HomeMy WebLinkAbout1729 E 4th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RS7 RESDNTI SINGLE FAMILY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of PotT Angeles
(Location Code 0502)
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Application Number
Application pin number
Properly Address
ASSESSOR PARCEIJ NUI\{BER:
Applicalion E]?e descr:iption
Subdivision Name
Prope:rtsy Use
Property Zoning
Application valuation
18 00000809 DaEe 5/30/78
a994',7 7
1129 E 4TH ST
06 30 00 5 5-0r50-0000
ELECTRICAI, ONLY
Application desc
Bat.hroom remodel
Contraclor
IIURD DAVID L
2009 w 15Tfl ST
PORT ANGEIES wA 983515130
Permit
AddiEional desc
Perfirit Fee
Issue Datse
Expiration Date
58.00
5 /30 /:LB
Lt /26 /la
ET,ECTRJCAI, AI]TER RESIDENTIAL
Plan Check Fee
Valualion
00
0
Qty Unit Charqe Per
1 .00 5 .0000 ECH
1.00 63,0000 ECE
Extealsiod
5.00
63.00
E], ECH AIDNT BRANCH CIRCUIT
EL.R- BRANCH CIR Wo/ SER FEED
Fee summary Charged Pa id CrediEed Due
PermiE Fee ToEal
Plan Check Total
Grand Tota]
58.00
.00
68.00
68.00
.00
68.00
00
00
00
00
00
00
INSPECTION TYPE RESTILTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN r lzt )tz >#v-
FINAL
COMMENTS:k
PERMIT WILL EXPIRE SX (6) MONTHS FROM LAST INSPECTION
Signature ofowner or Elect ical Contractor X Date
EXTRA MIIJE TECH & E]'ECT., I'I'C
418 N, RACE ST.
POR" ANGEI]ES VTA 98362(360) 457-5222
DATE:
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1 .2 SINGLE.FAMILY
Public Works and Utilities Depafirent
321 E. sdr Street, Pst Angeles, WA 98362
360.41 7.425 | www-cityofoaus I elecricalpermis@cityoftaus
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Project Addte€s:
Name:
i/tafling Address:
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Ol,VhfER INFGR1ItATION
ELECTRICAL CONTRACTOR INFOR!T,ENON
Name:Li:eGrc:€t<'hz.A4:r-lzlR-l
trr/tailing Addrgss ?o. itoa 3 t2.r ?v Lrr$L E qriE{ion Da6:/2-aa - 20t?
Email:Phone:3Lo4te | - Ort
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8!n iodF.rd.r 200 Allp.
ServicE Feee zof-aDAry-
Servicdtud64x600Alrp.
ssn iEdFss&r All-t000 Arp-
S€n i:/Flcder ougr !O0O Arp-
Brardr Cift it llwscntr Fadcr
Brardr qrcuitUlO S6r'!ia! Fe€der
Eaoh Artdond B.dl(,r Ct ar
Brandr Chsits 14
Tefip- SaMoa/Fe*r 200 Adp.
Terp. SqvirFs€dcr 20t-40o &tp.
nE{rD- Sen -G/Fee&r /Ot€00 AI?-
Erp. S€rric6F€sd€r 60t-100O4m.
PoitEl to Portd l{qdy
SigrlsN Ciqre,Litftd ErE g| - rE2 Cir.
UaruEculd lbrE Co.lrEdqr
RcrHi# Ebc' BEtly: g(lrA Sylbm a bsE
Thelttlo€ff (t{ob: $5 tuqadl additodl
ru€OS$sF..l
EdrlffodS0Oqetf
EdrOsEqr! rOoffiGrrfp
UrS*mfteturrHdTra
Ol.n0rt trEtsl lonrdfty r Udt Ch.rsc)
TOTAL (?tr''"
Or,rEr as (Hn€d by RC ,\419r&261: (1) olMterwiu oE Upy tha $u{ture rorirc yeas afierlhb €tsctriC pemn b fttaIad. (2) oryEerb
rEquilrd b hire an lEcfi,al €onbeEto. i, .!ovc aaid plopetv B for sle. Ilflt or le8. P6o.*t GrAlrEs sfur six morttnr ot lal hsp€cfon.
Afur rEading the abo,c staEncnt I hceby csr& tM I am the owner of the ahre naned pro!€ity or a licansed eEdical cp factor. I
am mddrg lhe el€ctaal in8tsflalion or albrdirn in cffD[ancew r the el€cbical hfls, rfEC-, RCl , Cn# 19.28, !r{AC. Cnlpilr 296-
464. The of P6tA,rgdc. Munidpd Codc, and Umy $q.rHiolts rrd PAIE ,a.05,05O rrgardrE EHid Prrnit Apfic.tk ns-
2t
Oate Print Name Sig[lturB (fl O3ller Ehctical ConEacbr / Admidstrabr)
3120-00
$146.00
@5-00
@zm
$373-00
$5.00
6.00
s.00
$-/5.00
593.00
slr 0-00
$r49.@
$68.q)
s.00
$64-00
t120.ff)
9102.00
s6.00
$a-(I)
$10.@
gr4.m
31r0-00
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PROJECT DETAILS
lElecficalPemitApdicatbrBmaybesubm.dbCilyHaIorelecticalpemi@ima.usorfaedb360-417-471t1
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