HomeMy WebLinkAbout728 E Front StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
COMMERCIAL ARTERIAL
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
-.5
t
*D
(N
$\
ApplicaEion Number
Applicats j.on pin number
Property Address
ASSESSOR PARCEL NU}'IBER:
Appfication lype descripcion
su.bdivision Name
ProperEy Use
Property Zonj.ng
ApplicaEion valuation
19- 0000193 5 DaXe L2/O6/L9
983875
728 E FROIIT ST
06 -30- 00 -5 - 1- 2200- 0000-
ELECIRICAI OIILY
Application desc
LighLing Rebate
Cont!actor
ROBERT G GERIVL\N JR
3325 E MASTERS RD
PORT ANGEIES
SIMPSON ELECTRIC
243 035 l{ HWY 101
PORT ANGELES
\360) 45't -921O
wA 983624749 tiA 98353
PermiE
Additsional desc
Per:mit Pee
Issue Date
Expi.ation Date
ETECTRICAI, AITER COMMERCIAI-
1'4 CIRCUITS
86,00 Plan Check Fee
12/A6/19 valuaLion
6/a3/20
00
0
Qty Uni! charge Per
BASE FEE
Extension
86.00
Charged Paid Creditsed Due
Permit Fee ToEal
Plan Check Totsa1
86 .00
.00
85 .00
86. 00
. o0
86.00
.00
.00
.00
00
00
00
PERMIT WILL EXPIRE Slx (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN ole lt ffi F,"
FINAL tzhslh AT N
COMMENTS
Signature of owner or Electrical Contractor X Date
IV U I-FAIVI ILY i COIMTMERCIAL
ELECTRICAL PERTVIIT APPLICATION
Public \l'orks and Utilities Depaltment
3:l f, 5th Street. PortAnscles. \trA 98-162
160..1i 7.47.15 | u,rvia,.cirr.otpa. us i c lectricaiperm its,Ztcirl,of pa.us
Project Address Habital for Humanity 728 E Front St. Port An qEIES , wA 98362
oci^htt'l"to
r ?0t!
Project Description Liqhtinq Rebate for Weatherwise Service P rog ram
n Multi-Family Residential E Commerciat / tndustriat / Public Buitding Square footage
Name Nancy German Email
Mailing Address Phone
Name Simpson Electric LLC ll6gnss SIMPSEL9T3RQ
Mailang Address: P.O. Box 1086 Port Anqeles,WA 98362 Expiration Date 12-11-21
Emarl dlsimpson5l @omail.com Phone 360-457 -92't O
Item
Service/Feeder 200 Amp.
Service/Feeder 20'1 -400 Amp
Servrce/Feeder 401 -600 Amp.
Service/Feeder 601 -1 000 Arnp.
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 401,600 Amp.
Temo Servtce/Feeder 601-1000 Amp.
Portal to Portal Houdy
Sign / Outline Lighting
Signal CircuiVLimited Energy - Multi-Family
Signal CircuiVLlmited Energy/First 1500 sf - Commercial
(Note $5 00 for each additional '1500s0
Renewable Elec Energy: 5KVA Syslem or less
Thermostat (Note. $5 for each additional)
Ouantitv Iolal (Ouantity x Unit Charge)lJdfchalse
$132.00
$'160.00
$225 00
$288.00
$410 00
$5.00
$74 00
$5.00
$86.00
$102.00
$'121.00
$164.00
$18s.00
$96.00
$88.00
$88.00
$96.00
86.001-4
$
$
I
$
$
$
$
$
$
$
$
$
$
U
$
$
$
$
$113.00
$56.00
$ 86.00 rorAL
Owner as defined by RCW'19.28.261 : (1) Owner will 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, rent or lease. Permit expires after six months of last inspection.
After 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., ReW Chapter 19.28, WAC. Chapter 296-
46B, The City of Port Angeles lvlunicipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
121512019 Andrew P Simpson 4"ZLr*p
Date Print Name Signature (! Owner p Electrical ractor /Administrato0
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417 .47111
.ELcoM
qjgEla
o
=I
+
IT
l-Dl\nt\
OWNER INFORMATION
ELECTR]CAL CONTRACTOR INFORMATION