HomeMy WebLinkAbout1129 W 12th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-473s
RS7 RESDNTIJ S]NGI'E FAM]LY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application Number
Application pin number
Propertsy Address
ASSESSOR PARCEL NUIVIBER:
Applicatsion, ty?e description
Subdivision Name
Property use
Property Zoning
Application valuation
18 - 00001795 Dare 11/30/18
473350
1129 W 12T!t ST
0 5 - 3 0 - 00- 0 -3 - s4 s I - 0000 -
EITECTRfCAL ONLY
Application desc
New home
ELSTBOM JR, ARI,AND
PO BOX 1402
PoRT ANGELES
NORTH PENINSI'LA EI,ECTRIC
761 ERESHWATER PARK RD
PORT ANGEIJES WA 98353
(360) 4'77-1764
wa 98352
Permit
Addilional desc
Permit Fee
Issue Date .
Expirat.ion Datse
160 .00
17/3a/lA
s /29 /le
ELECTRICAI, NEW RESIDENTIAI
vtan cneck !'ee
VafuatioI1
.00
0
Qty units Charge Per
1.00 120.0000 EcH
1.00 40.0000 EcH
EI,-R-SOFT EIRST 13OO
EL-R-SQFT A.DDITIONAI] 5OO
Extension
120.00
40. oo
Fee summary Charged Paid Credited Due
Petmrt !'ee'10ta1
Plan Check ToEal
Grand Total
150 .00
.00
160 .00
150.00
. o0
150.00
00
00
00
.00
. o0
.00
PERMIT WILL EXPIRE Slx (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERYICE
ROUGH.IN nho t B -P d>
FINAL iltl n &+
COMMENTS:
Signature of owner or Electrical Contractor X Date:
1 .2 SINGLE:FAMILY
ELECTRICAL PERIVI IT APPLICATION
Pr"rblic -rtr ori<s and {,:tiiities i}cpartmcnt
i2l h-.5th Silecl, Po!1.,\neeles. *.ii98362
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160.417.,17-l5 l lvr it .c irycripa. us l clcctricalg:crnrnsiri.:cii;'o il2a.us
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Project Addressl
Name:
Mailing Address
Name:
Illailing
-l .. tPrqiect Descriptlon
t4single-Family Residentiat I Duplex i ARU Buildjng Square footage
U=-
.f:1
Ci, \r\i-:=L 1'-\(-r -'i-Phone
'.<i-ticense
Expiration Date
\-''l l-.
Address
Email
Item
Servics/F8eder 200 Amp,
Servic6/FEeder ?01 -400 Amp.
Servica/Feeder 40!€00 Amp
Servica/Feeder 60 1 -1 000 Amp.
ServicPjFeeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit W/O SeMce Feeder
Each Additional Branch Cirorit
Branch Cirorits 1-4
Ternp. Servic€r'Feeder 200 Amp.
Temp. Servkre,/Feeder 201-400 Amp.
Temp- SeMcelFeeder 401400 Amp.
Temp. Se.vice/Feeder 60 1 -1 0O0 Amp
Po(al to Porlal l-lourly
SiEnal CirqJirAimited Energy - l&2 OU.
Manufac{ured Home Connedion
Renewable Elec. Energy: sKVA System or less
Theffiosiat (Note: 55 tur each additional)
First 1300 SquaE Fset
Eacfi Additional 50o square &ef'
Each Oubuilding / Detached GErage
Each Swirnming Pool / Hot Tub
Phone:
Iqb[ (Quantity x Unit Charge]Unit Charoe
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
s63.00
$5.00
$75 00
$93 00
s110.00
$149-00
$168.00
$96.00
$64.00
$120.00
$102.00
$s6-00
c120.00
$40.00
$74.00
$110.00
$
$
s
$
$
$
$
$
$
s
$
I
$
$
$
$
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$
s -i--,---7--'-
ll. \TOTAL
Owner as defined by RCW19.28.261: (1) Owner wil occupy the structure for two years after this electrical p€rmit rs finalized. (2) Owner is
required lo hire an eleclrical contrsclor rf above said property ls for sale, rent or lease Permit expires after six months of tast inspeclion
Afier reading the above statenrent, I hereby certat thal I am the owner ofthe above named property or a lic€nsed electrical conlractor I
am making the electrical installation or alteration in compliance wilh the electrical N.E.C., RCW Chapter 19.28, WAC. Chapter 296-
468, The City ol PortAngeles nrcipal Code. and Utility Specifications and 4 05.050 regard;ng Ele claic€l Permit Applications
Date Print Name
IElectricEl PsrmitApplicalions may
Sign ature n Electrical Contractor / Administrator)
be submitted to City Hall or el ermits@cityofua.us or faxed to 360.417.47111
Quantitv
I
ELECTBICAL INSPECTION
WIRING REPOHT
417-{135
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PERT1 T#$-nqF'INSPECTOE".rF+
OV,/\ER
CCNIBAqTOF
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ADDNESSnzh nl "tZ-
APPBOVED NOT APPROVED
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ROUGH INICOVER . ,
SERVICE
FINAL,...
D CORqECTIONS NEEDED:(€e-t ?aofe.-<q /--b"t),.IDtraY
e'$TUq-Y
a 6nt s>-t orsf qtVE-ou1-z_f_-[--
)Krnev ce^-Ii.l E-eXor-z-l'LV" bs+c
NOTIFY INSPECTOR WHEN CORRECTIOIIS
ARE COMPLETED wlTHIN 15 DAYS
-OO NOT REMOVE-
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