HomeMy WebLinkAbout917 Madeline St (2)Applicatsion Numbe!
Application pin number
Property Address
ASSESSOR PARCEIJ NI'MBER:
Application Eype descrj.ptio
Subdivision Name .
Property Use
Property Zoni-I1g
Appliiation valuation
19- 00000521 rlate 4 /12/19
444997
9].7 MADEIIINE ST
05-3 0- 01- ? - 6- 0220 - 0000 -
ELECTRICAIJ ONIJY
ELECTRICAL PERMIT
CTTY OF PORT ANGELES
3604174735
RS9 RESDNTIJ SINGLE EAMILY
0
REFORTST]ATESALES TAX
on J@ur excrs tax fqm
to the Ctty d M Angeles
(Locatlon bde050'12)
Applicatsion desc
Temp Service
JOEL C AND TAMARA L ELLIOT'T
P O BOX 2 951
SEQUTM WA 98382
'350) 46!-2t4s
UPPER LEFT ELECTRIC LLC
1306 ROOK DR
PORT ANGEL.ES WA 983 52
1350t 467-1'120
Permit
Addit.ional desc
Permit Fee
lssue Date
Expiration Datse
93.00
4/t2/19
aa/a9/t9
EI,ECTRICA! TEMPORARY SERVICE
Plan Check Fee
Valuatsion
00
0
oEy Unit Charge Per '
1.OO 93.OOOO ECH EL,TEMP SRV O-2OO SRV FDR
Extension
93 .00
Fee summary Charged Pa id Creditsed Dr.re
Pernit Pee Total
Plan Check To!a1
Grand Total
93 .00
.00
93 .00
93.00
.00
93 .00
. o0
.00
.00
.00
.00
,00
PERMIT WILL EXPIRE SIx (6) MONTHS FROM IAST INSPECTION
INSPECTION TYPE DATE:REST'LTS:INSPECTOR:
DITCH
SERVICE q)Dln
"8P SL/
ROUGH-IN
FINAL q)nln 60
COMMENTS:
t
Signature ofowner or Electrical Contractor X DstB:
CootracEor
#
EL{-2 sF
ELECTRICAL PERMIT APPLICATI ON
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 I www.cityofpa.us I electricalpermits@cityofpa.us
1'o
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NlI(A
N
RECEIVED
APfl 9 mlg
Project Address
POect Description
E Single-Family Residential E Duplex / ARU Building Square footage
OWNER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
PROJECT DETAILS
l\ilailing Address
Name: L'
Email:
Phone
fc-License
Expiration Date
Phone:
Quantitv fgB! (Quantity x Unit Charge)
-t <.@-
[/ailing Address
Email
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 Amp.
Service/Feeder 40'1 600 AInp.
Service/Feeder 601-1 000 Amp.
SeNice/Feeder over 1000 Amp.
Brancfi Circuit W Service Feeder
Brancfi Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201400 Amp.
Temp. Service/Feeder 40 1 $00 Amp.
Temp. Service/Feeder 601-1 000 Amp.
Portal to Portal Hourly
Signal CircuiuLimited Energy - l&2 DU.
Manufaclured Home Conneclion
Renewable Elec. Energy: sl(VA System or less
Thermostat (Note: $5 for each additional)
First 1300 Square Feet
Each Addfional 500 square feet"
Each Outbuilding / Detached Ga.age
Eacfi Swimming Pool / Hot Tub
t nit Charoo
$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
s110_00
-T
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$zTl-4jTOTAL
Owner as defined by RCW.19.28.261: ('1) Owner will occupy the struclure for two years afrer this electrical permit is finalized. (2) Owner is
required to hire an electrical contraclor if above said property is for sale, rent or lease Permit expires afler six months of last inspection
After readang the above statement, I hereby certiiy that I am the owner of the above named property or a licensed eiectrical contractor I
am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW Chapter 19.28, WAC. Chapter 296-
City of PortAngeles Municipal Code, and Utility 050 regarding Electrical Permit Applications
/ Adminiskator)
[Electrical Permit Applications may be submitted to City Hall or epermits@cityoha.us or faxed to 360.417.47111
1 - 2 SINGLE-FAMILY
Name: