HomeMy WebLinkAbout812 W 4th St (2)Application Number
Applicatsion pin number
Property Address
ASSESSOR PARCEL NUIVIBER :
Application Lype description
subdiwision Nane
Property Ose
Ploperty zoning
Applicatio valuation
RS7 RESDNTL SINGI]E FA}TIIJY
0
19- 0000090? Datse 6 /a3 /79
047087
812 W 4TI{ ST
06-30- 00 - 0- 1- 0205 - 0000-
EI,ECTRICAI ONLY
REPORT STATE SATES rIX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
:$
-so
Appfication desc
Ductless heat pump
Owner Contsractor
Iris Ei[ch Hesion
812 W 4ItI ST
PORT ANGELES
1360) 45O-7229
BI.ACK DIAMON'D ELECTRICAL COI IR
502 BI,ACK DIAMOND RD
PORT ANGELES WA 9A353
(350 ) 565-1035
wA 983532107
Permit
AddiEional desc
PermiE Fee
lssue DaEe
Expiration Da!e
63 .00
5 / :13 / t9
t2 / to /!9
ELECTRTCAI ALTER RESIDENTIAL
Qtsy Unit Charqe
1.00 53.0000
Plan Check Fee
Valuation
.00
0
Per
EI,.R. BRANCIT CIR WO/ SER FEED
Extens i,on
63 .00
Fee summary charged Paid Credi-Eed Due
!]erm.Ic I'ee 'l'oEa-t
PIan Check ToEal
Grand Total
63.00
- 00
63_00
53 .00
.00
63.00
00
00
00
00
00
00
PERMTT WILL EXPIRE SIX (6) MONTHS FROM LAST TNSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN e /zuln rAF :BP
FINAL a l*ln p EP
COMMENTS:
Sigmture of owner or Electrical Contractor X Date
ELECTRICAL PERMTT
CITY OF PORT ANCELES
360417-4735
ELECTRICAL PERM IT APPLICATION
Public Works and Utilities Department
321 E- 5th Street, Port Angeles. WA 98362
360.411 -4735 w'ww.cityofpa.us j electricalpermits@cityofpa.us
REcEIVTD
JUN fi llit sle
TProject Address:
ct Description
tL u '/7*btr-rzasJ
Single-Family Residential n Duplex / ARU Building Square footage
lvlailing Address
Email
Phone o- 72
ELECTRICAL CONTRACTOR INFORMATION
Name
Mailing Address
Email:
License
Expirati
Phone:
on Date
36a /-
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401600 Amp.
Service/Feeder 601 -1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit WO Servic€ Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201400 Amp.
Temp. Service/Feeder 401$00 Amp.
Temp. Service/Feeder 60'1 -1 000 Amp.
Portal to Portal Houdy
Signal CircuivLimited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: 5KVA 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
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
$ 11 0.00
Ouantitv IglE! (Quantity x Unit Charge)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
/ -, ------#-TOTAL
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 inspection.
After reading the above statement, I hereby certify that I am the owner of the above named prope.ty or a licensed electrical contractor I
am making the electrical installation or alteration in compliance with electrical laws, N E.C., RCW Chapter 19.28, WAC. Chapter 296-
468, The City of PortAn Muni Code and Utility S PAMC'14.05.050 regarding Electrical Permit Applications
6 -tl"tr.J
Date Print Name tu re Owner ! Electrical Contractor / Administrator)
[Electrical Permit Applications may be submitted to ty Hall or epermits@cityofpa.us or faxed lo 360.417.47111
ELl-2 sF
1 - 2 SINGLE-FAIVILY 1'ol
rll
O\NNER INFORMATION
Name: