HomeMy WebLinkAbout810 I StApplicacion Nuniber
Appllcation pln number
Property Address
ASSESSOR PARCEL NUIV1BER:
Application ts)'pe description
Su.bdivision Name .
Property Use
Property Zoning
Application valuation
Oroer
ELECTRICAL PERMIT
CMY OF PORT ANGELES
360-41',7-473s
RS7 RESDNTL SINGI]E FAMILY
0
f9- 0o0oo32 7 Date 3/O6/L9
'71,641A
810 r sT
06- 30 -00- 0 -2 -5200- oooo -
ELECTRICAIJ ONIJY
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ConEractor
TRACEY AXD CYNTIIIA ATMOM)
PO BOX 1553
PORT ANGEI]ES I{A 98362
O'iNER
Permits
AddiEional desc
Permlt !ee
Issue Date
ExpiraEion Date
DHP
63
3/05
9/02
ELECTR]CAI, ALTER RESIDENTIAL
.00
/7e
/L9
Plan Check Fee
Valua!ion
Permi! Fee Totsal
Pl-an Check Totsal
Grand Total
53.00
.00
63.00
63.00
.00
53 .00
.00
.00
,00
.00
.00
.00
0
Qty Unit Charge per
1.OO 53.OOOO ECH EIJ'R' BRANCH CIR WOl SER FEED
Bxtension
53 .00
Fee summary charged
REPORT STATE SATES TAX
on your excise tax form
to the City of Poft Angeles
(Location Code 0502)
INSPECTION TYPE DATE:RESULTS INSPECTOR:
DITCH
SERVICE
ROUGH-IN slr-ln N -$N
FINAL , )A)s -BP
COMMENTS:
PERMIT WILL E)(PIRE StX (6) MONTHS FROM LAST INSPECTION
Signature of ow:rer or Electrical Contractor X Date:
. o0
Paid Credi.led Due
Er {-2 SFLL
ELECTRICAL PERM IT APPLICATION
Public Works and Utilities Department
321 E.5th Street, Port Angeles, WA98362
360.417.4735 | www.cityofpa.us I electricalpermits@cityofpa.us
RECIiVED
ilAR 05 20lt
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Project Address:gi) e <+L
Project Description Trsiol feq) ond )jsconne/ {or ner,,, I>./less l/*/ fiuuT
E Single-Family Residential ! Duplex / ARU Building Square footage
Name
Mailing Address
Email
Phone 3@-46 3237
OWNER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
Name License
Mailing Address
Email:
Expiration Date
Phone:
PROJECT DETAILS
Item
Service/Feeder 200 Amp
Service/Feeder 201-400 Amp
Service/Feeder 40'1600 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
Iemp. Service/Feeder 201100 Amp.
Temp. Service/Feeder 40'1S00 Amp
Temp. Service/Feeder 60'1 -1 000 Amp
Portalto Portal Hourly
Signal Circuivlimited Energy - 1&2 DU
Manufactured Home Connection
Renewable Elec. Energy: sl(VA System or less
Thermostat (Note: $5 for each additional)
First 1300 Square Feet
Each Additional 500 square feet"
Each Outbuilding / Detached Garage
Each Swimming Pool / Hot Tub
After reading the above statement, I hereby certify
am making the electrical installation or alteration in
468, The City of PortAngeles l!!uniopal Code, and
-1-
Date
Unit Charoe
$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
$74.00
$110.00
Ouanttv fgtal (Quantity x Unit Charge)
L3,6D
$
$
$
$
$
$
$
$
$
U
$
$
$
$
$
$
$
$
$
$
$
$
$TOTAL
Owner as defined by RCW 19.28.261r (1) Owner will occupy the structure for two years afier this electrical permit is finalized. (2) Owner is
required to hire an electrical contractor if above sajd prope(y is for sale, rent or lease. Permit expires after six months of last inspection.
that I am the owner oI the above named property or a lic€nsed eleclrical contraclor. I
compliance with the electrical laws, N. E.C., RCW Chapter 19.28, WAC. Chapter 296-
Utility Spe SA d PAMC 14.05.050 regarding Eleclrical Permit Applications.
Print Name ignature (Owner ! Electrical Contractor / Administrator)
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417.47111
1 - 2 SINGLE-FAMILY