HomeMy WebLinkAbout811 W 15th Stapplicatiorl Number
Application pin number
Property Address
ASSESSOR PARCE! NUMBER:
Application t!'pe description
Sulcdlvision Name
Property Use
Property zoning
Application vahratsion
19- 000013 90 Dare 9/t7/t9
649020
811 W 151'l{ ST
06- 30 - 00 - 0-4 - 15a5 - 0000 -
EIECTRfCAL ONI,Y
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-473s
RS7 RESDNTL SINGLE FAMILY
0
REPORT STATE SATES IAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
AppLicaEion desc
53 .00+5 .00 branch circuiEs
Rogers, clenn
811 !.t 15 Lh
PORT ANGEIES
Oh.}IER
wA 98353
Permit
Additional desc
Permlc !'ee
Tssue Date
Expiratsion Dale
68.00
9/a7/19
3/Ls/2a
EIJECIRf CAI ALTER RESTDENTIAL
Plan Check Fee
valuaEion
00
0
Qty UniE Charge Per ExEension
58 .00
Fee summary Charged Paid Credited L\re
Permit Eee Total
Plan Check Total
Grand Total
58 .00
.00
58 .00
58 .00
.00
58.00
.00
.00
.00
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN q/r't )n *
FINAL 91 t't /ts P
PERMIT WILLEXPTRE SIX (6) MONTHS FROM LAST INSPECTION
Signature ofownq or Electrical Contractor X Date:
BASE EEE
.00
.00
.00
l#SP
COMMENTS:
Ll-2 sF 1-2SING LE-FAMILY
ELECTRICAL PERM IT APPLICATION
Public trbrks and Utilities Department
32 I E. sth Street, Port Angeles, WA 98362
360.4 17.47 35 r www.cityofpa.us I electricalpermirs@cityofpa.us
'r*
RECEIVED
sEP l2 2019
!o
3
It \0
I
*
N
Project Address
Project Description
/-D*3
E Single-Family Residential Duplex / ARU Building Square footage
Name:
Ivlailing Address
Email ,adY1
Tt?
OWNER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
Name:License
l\ilailing Address
Email:
Expiration Date
Phone:
PROJECT DETAILS
Itcm
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 WO Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401$00 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portalto Portal Hourly
Signal CircuiuLimited Energy -'l&2 DU.
Manufactured Home Conneclion
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
First 1300 Square Feet
Each Additional 500 square feet"
Each Outbuilding / Detached Garage
Each Swimming Pool / Hot Tub
lJnit 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
Ouantitv fglal(Quantity x Unit Charge)
te"
I
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
ITOTAL b8
Owner as defined by RCW 19.28.261. (1) Owner wrll occupy the structure for two years after this electrical permit is finalized. (2) Owner is
required to hire an electrical contractor if above said property is for sale, .ent or lease. Permit expires after six months of last inspection
Afrer reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor I
am making the electrical installation or alteration in compliance with the electrical laws, N E.C., RCW Chapter 19.28, WAC. Chapter 296-
468, The City of Po(Angeles l\,Iunicipal Code. and Utility Specifications and '14.05.050 regarding Electrical Permit Applications
Date Print Name Signature r E Electrical Contractor /Administrator)
lElectrical Permit Applications may be submitted to City Hall or epermits@cityoha.us or faxed to 360.417 .4711j