HomeMy WebLinkAbout723 E 4th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RS7 RESDNIL SfNG!E FA]VIILY
0
REPORT STATE SAI-ES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
-D\
&
60$\
Application Nurtser
Application pio number
Property Address
ASSESSOR PARCEL NUMBER:
Application t),pe description
Subdivision Name
Property Use
Property zoning
Applicacion vafuation
19 00001885 DaEe LL/26/19
952570
723 E 4TI{ ST
06- 30- 00 - 6 - 0- 0075 -0000 -
EIECTRICAI ONIY
Appl icatron desc
Relocate heater
Contractor
YMCA
302 S, FRANCIS
PORT ANGEIES
OI,INER
wA 94362
Per1rlits
Additsional desc
Permits Fee
Issue Date
Expiration Date
14.04
1t/ 26 / 19
5/24/2a
ELECTRICAI, ALTER COMMERCIAI,
Pfan Check Eee
valuation
00
0
otv
1.00
Units Charge
74.0000
Per
ECTI EL.COMM BRANCH CIR WO/ S/F
Extension
74 .00
Charged Paid Credited Due
PermiL Fee Totsa1
Plan Check Totsal
Grand T'otsal
14.40
.00
7rr .00
14.04
- 00
74_04
00
00
00
.00
.00
.00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN u )zz/ fr er -*tr
FINAL ti)4't lfi I d/
COMMENTS:
Signa ture of owner or Electrical Conaactor X Date:
MULT I-FAMILY / COMMERCIAL
ELECIRICAL PERM IT APPLICATION
Public Works and Utiiities Deoartment
321 E. 5th Street. Port Angeles. \LA 9
364.417.473
TJ
5lwww.cityofpa.uslel.7 23 a
8362
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Project Address
Project Description
E Multi-Family Residential EI Commercial / lndustrial / Public Building Square footage
c a NEN IilALL
O\^NER INFORMATION
Name UU
Mailing Address 307 5 FBnDct<9r Phone .? z/4
ELECTRICAL CONTRACTOR I NFORMATION
Name:License
lvlailing Address
Email:
Expiration Date
Phone:
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 40'1S00 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 '14
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 20't -400 Amp.
Temp. Service/Feeder 401S00 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Sign / Outline Lighting
Signal Circuiulimited Energy - Multi-Family
Signal Circuivlimited Energy/Farst '1500 sf - Commercial
(Note: $5.00 for each additional 1500 s0
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
Ouantitv Iqb!(Quantity x Unit Charge)
71ot)
Unit Charoe
$132.00
$160.00
$225.00
$288.00
$410.00
$5.00
$74.00
$5.00
$86.00
$102.00
$121.00
$164.00
$185.00
$96.00
$88.00
$88.00
$96.00
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
l/'
$113.00
$56.00
TOTAL
Owner as defined by RCW 19.28.26'1: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is
required to hire an electrical cgntractor 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 certiry that I am the owner of the above named property or a licensed electrical contractor I
am making the electrical installation oralteration in compliance with the electrical laws, N.E.C RCW Chapter'19.28, WAC. Chapter 296-
468, The City of Port Angeles Mu nicipal Code and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Date Print Name Signature @ Owner ! Electrical Contractor / Administrator)
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417 .4711|)
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