HomeMy WebLinkAbout934 W Lauridsen BlvdELECTRICAL PERMIT
CITY OF PORT ANCELES
360-4t'7-4735
RES IDE}TTIAL HIGH DENSITY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Poft Angeles
(Location Code 0502)
-s
6
6-
Appficatio Number
Application pin number
Property Address
ASSESSOR PARCEIT NUMBER:
Application t!?e description
subdivision Name . .
Property Use
Property Zoning
Applicat.ion waluation
19 - 00001815 DaEe lt/zo /r9
836800
934 W I,AURIDSEN BI,VD
06-30-09- s-0-0100- 0000 -
ELECTRICAL ONLY
Applacation desc
Pole lighE wiring
PENfNSUI.A HOUSING AUTHORITY
2503 S FRANCIS ST
POR? ANGELES I,IA 983 62
OWNER
Permit
Additional desc
Permit Fee
Issue DaEe
Expiration DaEe
74 .00
Lr/2A /a9
s/aB/20
ELECTRICAI ALTER COMI'IERCIAL
00
0
Oty Unit Charge Per
1-00 ?4.0000 ECH EL-coMM BRANCH cIR wol s/F
Extension
14 .OO
Charged Pa id Credited txJe
Per-mil Fee ToLal
Plan Check Total
Grand Total
?4 .00
.00
?4 .00
14.O0
.00
14.04
00
00
00
.00
.00
.00
PERMII WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION T}?E DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN ttlzz )fi ="N2 B>
FiNAL n"lzzltV ffi w(
COMMENTS:
Signature ofowner or Electrical Contractor X Date
Pl,an Check Fee
ValuaEi"on
ProjectAddress j\ tJ Lou
MULTI-FAMILY /COMMERCIAL
LECT APPLIC
Public Works and Utilities Department
321 E.5th Street, Port Angeles, WA98362
360.4 17.4735 | www.cityofpa.us I electricalpermits@cityofpa.us
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Project Oescription
Name:
hl 1,,.,
(^Email
Mailing Address Phone:3Co -fi)-1 tal 1
€,,r t,r r_r
Name: Licens€:
iilailing Address
Email:
Expiration Date
Phone:
ltm
Service/Feeder 200 Arnp.
Service/Feeder 201400 Amp
Service/Feeder 40'l 600 Amp.
Servic€/Feeder 601-1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Eranci Circuit W/O Servbe Feeder
Each Additional Branch Circuit
Branch Circuits ,-4
Temp. Service/Feeder 200 Amp
Temp. SeNice/Feeder 201-400 Amp.
Temp. Service/Feeder 401600 Amp.
Temp. Service/Feeder 601 -1 000 Amp.
Portal to Porta, Hourly
Sign i Outline Lighting
Signal Circuivlimited Energy - Multi-Famlly
Signal Circuivlimited Energy/First 1500 sf - Commercial
(Notei 65.00 foreach sdditional 1500 s0
Renewable Elec Energy: 5KVA System or less
Thermostat {Note: $5 br each additional)
Ouantitv Totrl (Quantity x Unlt Charge)Unit Charoe
$132.00
$160.00
$225 00
$288.00
9410.00
$s
$
$_
$
$86.00
$102 00
$121.00
$164 00
$185.00
$96.00
$88.00
$88.00
$96.00
$113.00
s56.00
$_
$--
$_
$
$_
$_
$
$_
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$_
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s
$
t TOTAL
Owner as defined by RCW 19 28.261: {1) Owner will occr.rpy the structure for two yeers after this electrical permit iE finalized. (2) Owner iB
requlred to hlrc an elecldcal contraclor if above said property is for sale, rent or lease, Permit €xpires aft6r six monthE of last lnspection.
After reading the ebove statement, I hereby certify that I am the own€r of the above named property or a liconsed electrical contractor I
am m aking the electrlc€l installation or alteration in compliance wilh the electrical laws, N. E. C,, RCW ChEpter 19.28 WAC. Chapler 296-
468, The city of Po.t Angeles Munrcipal code. and Utility specfications and PAMC 14.05.050 regarding Electrical permit Applicatrons.
Date Print Name Signature (8 .O,rre€r tr Electrical Contractor / Adm jniskato;)
lv1a4-3. -
400
[Electrical Permit Applications may be submifted to City Hall or epermits@cityofpa.us or iaxed to 360.4.17.471 1]
rELeoH
D Mutti-Family Residential E Commercial / lndustriat / Pubtic Buitding Square footage: _
OWNER INFORMATION
Iilcrf;im8n CONTRACTOR I
PROJECT DETAILS