HomeMy WebLinkAbout122 W 3rd StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417473s
RESIDEI{TIAL HIGH DENSITY
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Applicatsion Number
Application pin number
Property Address
ASSESSOR PARCEIT NUMBER I
Applicacion ts}?e description
Subdivision Name
Property use
Property zoning
ApplicaEion vafuation
19- 00001975 DaEe 1-2 /1-3 /L9
865056
122 W 3RD S?
06- 3 0- 00 - 0 - 0 - 7020 - 0000 -
ELECMICAL ONI-Y
Applicatsion desc
DHP
JACKIE L]ARDINE MOORE
122 W 3RD Sr
PORT NVGELES WA 9A3622A25
{503) 949-3033
BIACK DIAMOND ELECTRICAI, CONTR
502 BI,ACK DIAMOND R.D
PORT ANGELES VTA 983 63
(360) 56s-1035
Permit
Addicional desc
Permil Fee
Issue Datse
Expiration Date
53 .00
t2/1-3/re
6 / 1-o /20
ELECTRICAI AITER RESIDENTIAL
Plan Check Fee
valuation 0
oty Units Charge Per1,OO 63.0000 ECH EL-R- BR'ANCH CIR WOl SER FEED
ExEension
63 .00
Fee summary charged Paid CrediEed Due
Permit Fee Tot.al
Plan Check ToEal
Grand Totsaf
53 .00
.00
53 .00
53 .00
.00
53 .00
.00
.00
.00
00
00
0o
PERMTT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN n7,n ln -{F7 rF+P
FINAL n)xI
h "7 D YS
COMMENTS:
It
TI
Signa ture ofowner or Electrical Contractor X Date
.00
ELr-2 sF 2 SING E-FAMILY
ELECTR ICAL PERMITAPP ICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 I wx'w.cityofpa.us i electricalpermits@cityofpa.us
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RECIIVED
DEc t2 20ts
Project Address
Pro Description Dr:c+1955
Single-Family Residential E Duplex / ARU Building Square footage
Name
Mailing Address
Email
Phone Sa? I 30 33
O![NER INFORMATION
ELECTRICAL CONTRACTOR I NFORMATION
Name
Mailing Address
Email:
License
Exp Date
Phone.1s-
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Servic€/Feeder 401-600 Amp.
Servic€/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 14
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201400 Amp.
Temp. Service/Feeder 401.600 Amp.
Temp. Service/Feeder 6011000 Amp.
Porlal to Portal Hourly
Signal Circuiulimited Energy - '1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 br 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
$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
$110.00
Quantitv fdal (Quanuty r Unit Charge)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
I
$
$TOTAL
Owner as defined by RCW 19.28.261: (1) Owner will occupy the struclure for two years after this eleclracal permit is finalized. (2) Owner is
required to hire an eleclrical contractor if above sa;d property is for sale, rent or lease. Permit expares afrer 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 contraclor l
am making the electrical inslallation or alteration in compliance with the electrical E.C., RCW. Chapter'19.28, WAC. Chapter296-
46B, The City of PortAngeles nicrpalCode. and S 05.050 regarding Electrical Permit Applications
l2-tL-17
Date Print Name Si Owner ! Electrical Contractor /Administrator)
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed lo 360.417 .471'l)