HomeMy WebLinkAbout623 Vashon AveELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RS? RESDNTL SINGLE PAMII,Y
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
*a
&o\n
Application Number
Appfication pin number
P.operty Addresg
ASSESSOR PARCEL NTJMBER:
Applicat.ion Ey.pe descriptlon
Subdivi.sion Name , .
Property Use
Property zoning
Application valua!ion
19- 00000803 Date 5/29/t9
162229
523 VASHON AVE
06 - 30 - 10-4 - 3 - 0500 -0000 -
ELECTRICAL ON1Y
Applicatiolr desc
SERVICE FOR }I'\NUFACTORED HOME
Contractor
LOREITTZEN, PRISCILI.A
4012 NEWELT RD, APT C2
PORT ANGELES WA 983 63
SIMPSON EIJECTRIC
243 03 6 W HWY 101
PORT ANGELES
136a) 4s7 -92'7O
wA 98363
PermiL
AddiEional desc
Permit Fee
Issue DaEe .
Extr)iratlon Date
120 .00
5/29/te
tt/2s / te
ELECTRICAI, ALTER RXSIDENTIAL
P].an unecK t'ee
Vahrat ion
00
0
oEy Unit Charge per
1.OO 12O.OOOO ECH EL-MAN!' HOME SERVfCE & FEEDER
Extension
120.00
Fee summary Charged Pa id Credited Due
Permits Fee ToEal
Plan Check ToEal
Grand Tocal
120. OO
.00
120. 00
120.00
.00
120.00
00
00
00
00
00
o0
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST TNSPECTION
INSPECTION TYPE DATE:RESULTS INSPECTOR:
DITCH ulqln tr 1f
SERVICE ,,lR l" n tr .TAF
ROUGH.IN
FINAL b ),t1fl +r W
COMMENTS:
Signature ofowner or Electrical Contractor X Date:
ELECTRICAL PER MIT APPLICATION
Iririilic \\ r;r'1..i il rl i lili!jr\ j )r,ltiilljtt r't1t
ili ! ilr Sirci't frori ll=eies. \'r.\i)S.1,-,1
i6ri.li-:.i:.i: ,.\, \\'.i r-ii\,0ii!i1 Lrr riucit ti:rlf,crrt'|i\ rae ri1ol]i1l tLs
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3.
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Proj€ct aa6,"o. 623V6shon Ave Port Anoeles.Wa
Project DBscripti on. Pow€r for Manufactured Home
n Singl+Family Residential fl Duptex /ARU Buil ding Square foot ge:
fr|a66; TraMs & Priscilta Lorenben Email
Mailing Address Phone
Narne. Simpson Elecbio LLC License;SIMPSELST3RO
Expi ration Date: 1i,11D019
Phone: 360-2t57-9270
Mailing Address: P.O. Box 10gO Port Angeles, WA 98362
Email dlsimpsonsl@gmail.oom
Item
Service/Feeder 200 Amp
Service/Feeder 201 -400 Amp.
Seryice/Feeder 401-600 Amp.
SeMce/Feeder 601-1000 Amp.
Service/Feeder over 1000 Amp.
Btanch Circuit w/ Service Feeder
Branch Circurt WO Service Feeder
Eech Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Te mp. Servic€/Feoder 20'l-400 Amp.
Temp. Service,/Feeder 401600 Amp.
Temp. Service/Feeder 601-1 000 Amp.
Podal to Portal Hourly
Signal Circuiulimited Ensrgy - .l&2 DU.
Manutactured Home Connechon
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 tor each additional)
First 13OO Square Feet
Eadl Additonal 500 s$rare feet"
Eadr Outbuitding I Dst8ched Garaoe
Each Swimming Pool / Hot Tub
t nlt Charoe
$J20 00
$146.00
s20s.00
$262.00
$373.00
$5.00
s63.00
$5.00
$75.00
$93.00
$110.00
$149.00
$168.00
s96.00
$64.00
$120.00
$ 102.00
$56.00
$120.00
$40.00
$74.00
$1r0.00
ouandty treEl (Quan(ty r Unlt Charge)
120,00
$
I
s
$
$
$
$
$
o
$
$
$
$
$
$
$
$
$
$
$t
1
TOTAL 120.00
Owner as defined by RCW19.28.261: {1) Owner will occupy the slructire for tlyo years after this electrical permit is finalized. (2) owner is
required to hire an elec,lrical contractor if above said paoperty is for sale, rent or lease- Permit expires after six monhs of last inspedion.
After reading the above s,tatement, I h€reby certify that I am tho owner ofthe above named property ot a licensed elsctrical contactor. I
am making tho electrical instellalion or alteration in cornpliance with the eleckical laws, N.E.C., RCW Chapt€r 19.28, WAC. Chapter 296-
468, The City ofPortAogEles lllunicipel Code, Bnd Utility Speciticstions and PAUC 1it.05.050 regarding Et€ctical Permlt Apptications
512812019 Andrew P Simpson &"/.^zir-P
Dato Print Name Signature (E Owner p Eloc-Ui Cohtractor / Adn nistratoo
lElecttical Permit Applioalions rEy be submined to City Hall or electricalpernit$@cityofpa,us or faxed to 360,417,4711)
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