HomeMy WebLinkAbout1020 S Laurel St (2)-r)
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ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -4735
RS7 RESDNTL SINGI,E EAMILY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Poft Angeles
(Location Code 0502)
Application Number .
Applicalion pin nuniber
Property Address
ASSESSOR PARCEI NIiMBER:
Application tl?e description
Subdivision Name
Property Use
ProperEy Zoning
ApplicaEion valuation . .
19 - oooo1997 Date t2/1-'t/1-9
294229
1O2O S I,AUREL S"
05 - 3 0 - 00 - 0-3 -27 90 - 000 0 -
ELECTRIC}I ONLY
Applicatiolr desc
MICHAEL AND KIM CHYI.IOWETH
C/O 2881 PINYoN AYE
GRAND JUNCTION CO 81501
BI,ACK DIAMOND EIECTRICAL CONTR
502 BI,AC( DIAMO\ID RD
PORT ANGELES WA 983 63
(350) 555-103s
Permi-t
AddiEional desc
Permit Fee -
Issue Date
Expilation DaEe
53 .00
a2/L7/L9
6/14/20
ETECTRICAIJ ALTER RESIDENTIAL
.00
o
QEy UniE Cllarge Per
I.OO 53.OOOO ECH EL-R- BRANCH CIR lIOl SER FEED
Extension
53. OO
Charged Paid Credited Due
Permit Fee Total
Plan Check Total
Grand Total
63 .00
.00
53 .00
63 .00
.00
53 .00
00
00
00
.00
.00
.00
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN a)o)e 4?
FINAL t2-lo/b A-3-
COMMENTS:l/
PERMIT WILL E)(PIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date
vafuation
#
%AF
L1-2 sF 2 SING E-FAMILY
EL ECTRICAL PERMITAPP ICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.4 17.4735 I www.cityofpa.us I electricalpermits@cityofpa.us
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Project Address
Description 4-.,
ngle-Family Residential n Duplex / ARU Buitding Square frootage
OWNER INFORMATION
Name Email
lvlailing Address: phone &t*t(,- t+lo
ELECTRICAL CONTRACTOR INFORMATION
Name:
[ilailing Address
Email:
0 License
on DateExpirati
Phone:to -46r >as-tT1
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 Servic€ Feeder
Branch Circuit WO SeNice Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Servic€/Feeder 200 Amp.
Temp. Service/Feeder 201100 Amp.
Temp. Service/Feeder 40'1600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Signal Circuiulimited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: sKVA System or less
Thermostat (Note: $5 for each additional)
First '1300 Square Feet
Each Additional 500 square feet"
Each Outbuilding / Deiached carage
Each Swimming Pool / Hot Tub
unit Charoe
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$5.00
$75.00
$93.00
s110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
$120.00
$40.00
$74.00
$110.00
Quantitv lqE!(Quantity x Unit Charge)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$a-TOTAL
owner as defined by RCW 19.28.261: (1) Owner will occupy the struc{ure for two years afier this electrical permit is finalized. (2) Owner is
required to hire an electrical mntractor 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 o. a licensed electric€l contractor I
am making the electrical installation or alteration in compliance y/ith the electrical laws, N. E.C., RCW Chapter 19.28, WAC. Chapter 296-
468, The City of Pod lCode and Utilrty and PAMC 14 05 050 regarding Electrical Permit Applications.
l?-lr -t
Date Print Name re(Owner I Electrical Contractor / Administrator)
I
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[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417 .47111