HomeMy WebLinkAbout1521 S Pine StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -4735
RS? RESDNTL SINGITE FAMII'Y
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Pori Angeles
(Location Code 0502)
-s
I
Oo
NI3Appficatioi Number
Application pin nulnber
Property Address
ASSESSOR PARCEL NU}4BER :
Application Ey'pe description
Subdivisioa Name
Property Use
Properly zoning
Appficatsion valuaEj"on . .
t 9 - 00001824 Date Ll/t9/t9
534848
1521 S PINE ST
05 - 3 0- 00 -0 -4 - 24 50- 0000 -
EIJECTRICAL ONLY
ContracEor
ELECTRICAL AI,IER RESIDENTIAI
Plan Check Fee
Valuation
.00
0
Qty Unit Charge Per1.00 53.0000 ECIr EL-R- BRANCH ClR WO/ SER FEED
!xtseIIsion
63 .00
Fee summary ClIarged Paid Credited Due
CORY TITMUS AND A}IDREA M KOIJES
1521 S PINE ST
PORT A.}IGELES WA 983521521
BIACK DIAMOND EI,ECTRICAI, CONIR
502 BI,ACK DIAMOND Rl)
PORT ANGELES IiA 98353(350) 565 1035
Permlt . .
Additional desc
Peroit Fee
Issue Date
Expiration Date
53 .00
t1-/t9/t9
5 /a7 /20
Pernit Ee
Plan Chec
Grand Tot
ToEaL
Totsal
53 .00
.00
53_00
53 .00
.00
63 .00
00
00
o0
00
00
00
k
a1
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION Tl?E DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN ela/n 4tr w
FINAL tdrlie +
COMMENTS:
Signature of owner or Electrical Contractor X Date:
Applicatsion desc
DHP
Er 1-2 SFLL 1 - 2 SINGLE-FAMILY
CTRICAL PERMITAPPLI
Public Works and Utilities Department
321 E. sth Street, Port Angeles, WA 98362
3 60.4 t7 .47 3 5 | www.cityofpa.us I electricalpermits@cityofpa.us
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-.trProject Address
Project Description:DucflZ{.-f
Si ngle-Family Residential D Duplex / ARU Building Square footage
Name
Mailing Address
Email:
Phone 3so -1ts- 'llor
OV1NER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
Name
Mailing Address
Email:
Expiration Date
Phone: 3Ao'{ct-3CSa
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201.400 Amp.
Service/Feeder 401 €00 Amp.
Service/Feeder 601-1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit w/ Service Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401$00 Amp.
Temp. Service/Feeder 601-1 000 Amp.
Portalto Portal Hourly
Signal CircuiuLimited 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 Charqe
$120.00
$146.00
$205.00
$262.00
$373 00
$5.00
$63 00
$s.00
$7s.00
$93.00
$110.00
$149 00
9168.00
$96.00
w.00
$120.00
$102.00
$56.00
$120.00
$40.00
$74.00
$110.00
Quantitv Iqhl (Quanuty x Unit Charge)
$
$
$
$
$
$
$
!
$
$
$
$
s
$
$
$
$
$
$
$
$
sTOTAL
Owner as defined by RCW19.28.261: (1) Owner will occupy the sfucture for two years afrer 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 certifo that I am lhe owner of the above named property or a licensed electrical contractor I
am making the electrical installation or alteration in compliance with the etectrical laws, N. E.C , RCW Chapter 19 28 WAC. Chapter296-
468, The City
tt-tb -\
of Port Angeles de,cations and PAMC '14.05.050 regarding Electrical Permit Applications
Date Print Name Signature (Owner ! Electrical Contractor / Administrator)
[Electrical Permit ApPlications may be submifted to City Hall or epermits@cityofpa.us or faxed to 360.4'17.47i 1]
License: _
