HomeMy WebLinkAbout622 S Francis StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-473s
IIST RESDNTL SINGLE FAMII,Y
0
REPORT STATE SALES IAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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sApplication Nunber
Application p j.n number
Propertsy Address
ASSESSOR PARCEI, NUI"BER:
appLication t!?e descripEion
Subdivision Name . .
Property use
Property zoni.ng
ApplicaeionvaluaEiofl -
19-00001325 Date g/29/79
674264
522 S FRANCIS ST
06- 30- 00 - 0-2- 05?5 - 0000 -
EI,ECTRICAI, ONLY
Applicatio$ desc
DHPx2
Oh'ner Contracto!
ERICKS DEE RTNEE
622 S FRANCIS ST
PORT ANGELES
BI,ACK DIA'.IOND EIJECTRICAN CONIR
5 O 2 BI.ACK DIAI'{OND R.D
PORT ANGELES WA 9A363
(350) s55-1035
wa 98u62641:]
Permit
Additional desc
Permit Fee
Issue Datse
Expiration DaEe
68 .00
I /29 / 1-9
2/25/20
ETECTRICAL AITER RES IDENIIAI,
Qty Unit Charge Per1.00 s.0000 ECH1.00 53 .0000 ECH
Plan Check Fee
ValuaEion
.00
0
EI,.ECH ADDNT BRANCH CIRCUIT
EI,-R. BRANCH cIR wo/ SR I'EED
Extension
5.00
63 .00
Charged Credited Due
Permlt Eee ToEal
PIan Check ToEal
crand Total
58 .00
.00
58 .00
58 .00
.00
68 .00
00
oo
00
.00
.oo
.00
PERMIT WILL EXPTRE SIX (6) MONTHS FROM I.A.ST NSPECTION
INSPECTION T\?E DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN ?ts-r t ltr
FINAI-7-ts-tc ,leD
COMMENTS:
I
TI
Signature of owner or Electrical Contractor X Date
lxD6
Er l-2 sFLL
CTRICAL PE APPLICATI
Public Works and Utilities Departrnenr
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 | www.cityofpa.us electricalpermits@cityofpa.us
RECEIVED
Itl{i t.q tgL9
oi
f
:..s
GN0-Prolect Address 2Lf (f
P Description
Single-Family Residential E Duplex / ARU Building Square footage
Name:
Mailing Address:
EmailL.l- 5 Phone ?oo n{z 2-7 2L
O!\NER INFORMATION
I
ELECTRICAL CONTRACTOR I NFORMATION
Name
lVlailing Address
Email:
License:
Expiratio
Phone:
n
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201 400 Amp.
Service/Feeder 401$00 Amp.
Service/Feeder 601 -1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 14
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 20 !-400 Amp.
Temp. Service/Feeder 40l€00 Amp.
Temp. Service/Feeder 60'l-'1000 Amp.
Portal to Portal Hourly
Signal CircuiuLimited Energy - l&2 DU.
l\4anufactured Home Conneclion
Renewable Elec. Energy: sKVA System or less
Thermostat (Note: $5 for each additional)
First '1300 Square Feet
Each Additional 500 square feet"
Each Oulbuilding / Oetached Ga€ge
Each Swimming Poot / Hot Tub
Date Print Name to
Quantitv lgtr! (Quantity x Unit Charge)
Owner ! Electrical Contractor / Administrator)
Unit Charoe
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$5.00
$75.00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120 00
$102.00
$56.00
$120.00
$40.00
$74.00
$110.00
$
$
$
$
$
$
$
$
!
s
$
$
$
$
$
$
$
$
$
$
$TOTAL
Owner as deflned by RCW 19.28.261r (1) Owner will occupy the struclure for two years afler this electrical permit is flnalized. (2) Owner is
required to hire an elec{rical contractor if above said property ls for sale, rent or lease. Permit expires afrer six months of last inspection.
After reading the above statement, I hereby certify that I am the owner above named property or a licensed electrical contractor. I
am making the electrical installation or alteration in compliance llaws, N.E.C., RCW Chapter'19.28, WAC. Chapter296-
468, The City of Port Ang s Municipal and Utility PAMC 14.05.050 regarding Electrical Permit Applications.
t-'L
[Electrical Permit Applications may be submitted Hall or epe us or faxed to 360.417.47111
1 - 2 SINGLE.FAMILY