HomeMy WebLinkAbout123 W 4th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RESIDENTIAI, I{IGII DENSITY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application Nunrber
Application pin nuiber
Property Address
ASSESSOR PARCEL NI]MBER:
Applicatrion tl4)e descriplion
subdivision Name
Properly Use
Property zoning
ApplicaEion valuation
19- ooooo 900 Date 5/t3/1-9
287a00
123 W 4II] ST
05-3 0- 00- 0 - 0 -7060- 0000-
ELECTRICAI, ONI,Y
Application desc
Temp Service
Owner Contsractor
catshy LaBefle
123 W 4TH ST
PORT ANGEIES
(253) 686 0505
SIMPSON ELECTR]C
243035 W I,iY 101
PORT ANGEI,ES
1360) 457 -921a
wA 9a353
Permit
Additsional desc
PeIrnit Eee
Issue Date
93 .00
6/13/te
72/tA/a9
ELECTRICAI, TEMPOFARY SERVICE
PIan Check Fee
valuation
00
0
Expi.ration Date
oEy UniE Charge1.00 93.0000
Per
ECl{III,'TEMP SRV O-2OO SRV FDR
ExEension
93 .00
Charged Paid Credited Due
Permi! Fee Total
Plan Check 1'oLal
Grand TotaI
93 .00
.00
93.00
93 .00
.00
93.00
00
00
00
00
00
00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTTON
INSPECTION TYPE RESULTS:INSPECTOR:
DITCH
SERVICE t/tt /rt p w
ROUGH-IN u
FINAI t /tz/n 4P €
t
Signa ture of owner or Electdcal Contractor X Date
wA 983522805
DATE:
COMMENTS:
ELECTRICAL PER MIT APPLICATION
Public r&brks and Lltilities Department
321 E.. -sth Shrer. Port Angeles, WlA 98_t62
160.4 I 7.4715 | u.rvw.citvofpa.us I electricalpennits@cityolla.us
RECEITED
tuN 20t9
1lo
3
$
*o
I.\bCio
Prol ect Address: 123 W 4th St Port Angeles
Project Descrip tion Temp Service
D Single-Family Residential E Duplex / ARU Building Square footage
Name Cathy Labelle Email
Mailing Address P hone .1-253-686-0505
Simpson Electric LLC License SIMPSEL9T3RO
Exp iration Date: 1211 112019
phone. 360-457-9270
lila iling Address: P.O. Box 1086 Port Angeles, WA 98362
E.";1. dlsimpson5 l @gmail.com
Item
Service/Feeder 200 Amp.
Service/Feeder 201 -400 Amp.
Service/Feeder 401 -600 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 Seryrce/Feeder 201-400 Amp
Temp Service/Feeder 401-600 Amp
Temp Servrce/Feeder 60'1- 1000 Amp
Portal to Portal Hourly
Signal CircuiUlimited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec Energy 5KVA System or less
Thermostat (Note: $5 for each additionat)
First 1300 Square Feet
$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
93.00
$
)
$
$
$
s
$
$
$
$
$
$
$
$
$
$
$
s
$
$
TOTAL $ s3'00
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 inspectaon.
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 electracal installation or alteration in compliance with the electrical laws, N.E.C., RCW Chapter 19.28, WAC. Chapter 296-
468' The City of Port Angeles Municapal Code, and Utility Specilications and PAMC 14.05.050 regarding Etectrical permit Applications.
611112019 Andrew P Simpson
Date Print Name Signature (E Owner p Electrical Contra r /Administrator)
IElectrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa. us or faxed to 360.4j7.47 j1)
1 - 2 SINGLE-FAMILY
OWNER INFORMATION
ETECTRIEAI OONTRACTOR I NFORMATION
Name:
PROJECT DETAILS
Ulitlx3lge Ouantitv fglel (Quantity x Unit Charge)
1