HomeMy WebLinkAbout1610 W 5th StAppfj.cation Nunber
Applicati,on pin nuliber
Property Address
ASSESSOR PARCEL NUMBER:
Appl j.caEion t),pe descriptlon
subdi.vision Name
Property Use
Property zooiog
Appliciation valuaEion .
ELEETRIEAL PERI4IT
EITY OF PORT ANGELES
360.417.473s
RS7 RISDN?L SINGLE FAMII-Y
o
19 - 00000555 Date 4/!9/t9
545988
1610 W 5TH ST
06-30-00-0-t -2810-0000-
ELECTRIOIJ ONIJY
REPORTSXATESALES TAX
on Wr excise tax fqm
to the Clty of PutArgeres
(Locatlon We0il2)
Application desc
Service change
Owner Contractor
WILLIAIiI J AID SHARON WESTREM ?
PO BOX',2829
SEQUIM WA 98382(360) 583-3414
ELECTRIC AMERICA
PO BOX 3523
SEOUIM
(360) 912-ss50
wA 98382
Permit .
Additional desc
Permrt !'ee
Issue Date
Expiration Date
120 .00
4/t-e/t9
Lo / L6 /t9
ELECTRTCAI, ALTER RESIDENTfAL
Plan Check Fee
Valuation
00
0
Qty Unit Charge
1. 00 120.0000
Per
ECH EL- O'2OO SRV FEEDER
Fee summary Cha.ged Pald Credited
Permit Fee Total
Plan Check Total
6!and Total
L20
L20
00
00
00
.00
.00
.00
00
00
00
420
720
00
00
00
INSPEETIO}IT1PE RBT}[.TS:Itr$PECIOR|;:
DIfEH
SER\reE vJzdn 'AF *
ROIJGF{N
FIITAL .tl2zlfi fr #
eob&dENtts:
I
TIII
PHMnS'&LE (mE$E(@NOr,!qffi FRO(!.ASrNoercmON
Signatre of ow, or Effiel &mmr *IDErr
ExLension
120.00
Due
DAIE
ELECTRICAL PERM IT APPLICATI ON
Public Works and Utilities Department
32 I E. 5th Street, Port Angeles, WA 98362
360.4 17.47 35 | www.cityofpa.us electricalpermits@cityofpa.us
!ol-*
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ts
\-'Project Address 1610 W.sth St. Port Angeles
Project Oescription Service Chanoe
E Single-Family Residential E Duplex /ARU Buitding Square footage
Name:erry Email:
Mailing Address Same as above phone: 360-912-4155
Name:menca License ecta
Mailing Address
Email:
P.O. Box 3523 Expiration Date
Phone:
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 Amp.
Service/Feeder 401{00 Amp
Service/Feeder 601-1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circult W/O Service Feeder
Each Additional Branch Clrcuit
Branch Circults 1-4
Temp Servrce/Feeder 200 Amp.
Temp Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp. SeNice/Feeder 601-1000 Amp.
Po.tal lo Portal Hour y
Signal Clrcuivlimited Energy - 'l&2 OU.
Manufactured Home Conneclion
Renewable Elec Energy: 5KVA System or less
Thermostat {Note 55 for each additional)
Firsl 1300 Square Feet
Each Additional 500 squsle tu€t"
Each Outbuilding / Deiached GsEge
Each Swimming Pool/ HotTub
Unit Charoe
$120.00
$146.00
s205.00
$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
s40.00
s74 00
1110.00
Quantitv Iqlal(Quantit x Unit Charge]
s 120.00
$
s
$
$
$
$
$
$
$
$
$
$
$
$
$
)
$
s
s
0 1?n nn
Owner as defined by Rc\ 119.28.261 . (1) Owner will occupy the structure for two years after this eleclrical permit is finalized. (2) O/ner iE
required lo hire an electrical contraqtor i, above said property is for sale, rent or leas€. permit expires after six months of last inspection.
Afrer reading the above statement, I hereby ceiify that I am the owne. ofthe above named property or a licensed electrical contrsclor. I
am making the electrical installation o. alteration in com pliance with the el , N,E.C,, RCW ChA pter 19.28, WAC. Chapter 295-
468, The City of Port Angeles Municipal Code, and U cificatio and c 4 50 regarding Electrical Permit Applications
16A r.2019 Stuart Duff
Date Print Name Signature (f)Electrical Contractor i Administrator)
IElectrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.47'l t ]
1 - 2 SINGLE-FAMILY
REcoys^
APD
a
OWNER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
PROJECT DETAILS
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