HomeMy WebLinkAbout2184 W 4th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RS7 RESDMXIJ SINGI'E FAMILY
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Pori Angeles
(Location Code 0502)
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N-llApplicatj.on Nunlcer
Application pin number
ProperEy Address
ASSESSOR PARCEI NUMBER:
Application t)'pe description
Subdivision Name
Propei!y Use
ProperEy Zoning
Application valuation
19-0000132? Date 8/29/19
752646
2184 W 4TH ST
06-30- 00- 9-4 -0024- 0000-
EIJECTRICA]' ONI'Y
AppficaEion desc
DHP
Contract.or
JOIIN S AJ{D JUDY C YANO
95756 MAIAKU ST
MII,II.ANI HI 95789
(808 ) 386-68?s
BI,ACK DIAMOND EIECTRICAL COMTR
502 BI-\CK DIAMOND RD
PORT ANGE1ES WA 983 63
(360) s5s-1035
Pernit
AddiEional desc
Permit Fee
Issue Date
Expiralion Date
63.00
I/2e /Le
2/2s/2o
ELECTRICAI ALIER RESIDENTTAI
Plan Check !'ee
Valuat.ion
00
0
oty Unit Charge per
1.00 63.0000 ECI] EL-R' BBANCH crR wo/ sER FEED
Extension
63 .00
Charged Paid Creditsed Due
Permit Fee Total
Plan Check Totsal
Grand Tolal
63 .00
. o0
53 .00
63.00
.00
63 .00
00
00
00
00
00
00
PERMIT WILL EXPIRE Slx (6) MONTHS FROM LAST INSPECTION
INSPECTION T\?E DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN q), hs K B>
FINAL IP
COMMENTS
,g')dlq
Signature ofowner or Electrical Contractor X Date:
ELl-2 sF 2 SING E-FAMILY
ELECTRI CAL PERMIT A PP ICATION
Public Works and Utilities Department
321 E. 5rh Street, Port Angeles. WA 98362
360.417.4735 w,w.cityofua.us i elecrricalpermits@cityofpa.us
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Project Address {
Project Description DJc-oait
Single-Family Residential E Duptex /ARU Building Square footage
Name:Email
Nlailing Address 2 rlit lr, ql+enone: to6-3tt,- ffr7f,
Email. phone
Name
lvlailing Address
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401600 Amp.
Service/Feeder 601-1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuil W Service Feeder
Branch Circuit W/O Service Feeder
Each Additional B.anch Circuit
Branch Circuits 14
Temp. Service/Feeder 200 Amp
Temp Service/Feeder 201{00 Amp.
Temp. Service/Feeder 401$00 Amp.
Temp Service/Feeder 60'1-1000 Amp.
Portalto Portal Hourly
Signal CircuiuLimited Energy - 1&2 Du.
Manufactured Home Connection
Renewable Elec. Energy: sl(VA System or less
Thermostat (Note: $5 for each additional)
First 1300 Square Feet
Each Additional 500 square feet"
Each Outbuitding / Detached Garage
Each Swimming Poot / Hot Tub
License
Expiration
Quantitv Igta! (Quantity x Unit Charge)Unit Charoe
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$s.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
s110.00
$
$
$
$
$
$
U
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Owner as defined by RCW19.28.261: (1) Owner will occupy the structure for two years afterthis eleclical permit is finalized. (2) Owner isrequired to hire an electrical contractor if above said property is for sale, rent or lease Permit expires after six months of last inspection.
After reading the above statement, I hereby cedify that I am the owner ot
am making the electrical installation or alteration in compliance
468, The City ol Port l\,I u n icipal Utilty
Date
TOTAL
named property or a licensed electrical contractor I
laws, N.E.C., RCW Chapter 19.28, WAC. Chapter296-
14 05.050 regarding Electrical Perm it Applications.
Print Name Owner ! Electrical Contractor/Administrator)
OWNER INFORMATION
ELECTRICAL CONTRACTOR I NFORMATION
PROJECT DETAILS
[Electrical Permit Applications may be submatted to Hall or eperm its@cityofpa.us or faxed to 360.4 j7.47.111