HomeMy WebLinkAbout1703 S B St (3)ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -4735
INDUSTR]A! LIGHT
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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d
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Applicatioo Numbet
Application pin number
Property Address
ASSESSOR PARCEI. Nt]MBER:
Application ts).pe description
subdivision Name
Property Use
Property zoning
Appfication valuation
19 - 00001871 DaLe Ll/27/t9
809520
1703 B ST
05 -3 0 - 00- 0-4 -4850 - 0000-
ELECTRICA! ONLY
Appllcat.ion desc
Water fi11io9 station
Contsractor
CITY OF PORT ANGELES
PO BOX 1150
PORT ANGELES WA 9A362A217
O17INER
Permit
Additsional desc
Permit. Fee
Issue Dale
Expiration Dai:e
'74 . aO
aa / 27 /a9
s /25 /20
ELECTRICAL ALTER COMMERCIAL
Plan Check Eee
valuat ion
00
0
Oty Unit Charge Per
1-OO ?4,OOOO ECH EL.COMM BRANCII CIR WO/ S/E
Extension
14.04
Fee summary Charged Paid Credited Due
Perrnit Eee Total
Plan Check Total
Grand Total.
74.00
.00
'74 .AO
.00
.00
.00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERYICE
ROUGH.IN nlz/n tr w
,irifiq *('*
COMMENTS:
Signature of owner or Electrical Contractor X Date:
?4.00
.00
'74 .04
- 00
- 00
.00
FINAL
Flcom IVULTI.FAMILY /COMMERCIAL
EL ECTRICAL P ERMI T PLICATION
Public Works and Utilities Department
321 E.5th Streer, Port Angeles, WA 98362
360.417.4735 | www.cityofpa.us I electricalpermits@cityofpa.us
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Pro.iect Address /7os s. Bs TK6 E(coKQ drao o"A
Project Description:GF P;r foR aA 'I 64 €uzt26 SfPTto,y'
E Multi-Family Residential E Commercial / tndustiat / public Buitding Square footage:
Name:Email
Mailing Address:h{dtle
I
Name: _
Mailing Address:
Email:
_ License:
It!m
Servic€/Feeder 20
Service/Feeder 2C
Servica/Feeder 4C
Service/Feeder60
Service/Feeder ov
Branch Circuit W
Branch Circuit W/(
Each Additional Br
Branch Circults 1-
Temp. Service/Feeder z0o Amp.
Temp. Service/Feeder 201{00 Amp.
Temp Service/Feeder 40'1600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Podal to Portal Hourly
Sign / Outline Lighting
Signal CircuiuLimiled En€rgy - Multi-Family
Signal CircuiUlimited Energy/First 1500 sf- Comme,cial
(Note: $5.00 tor eacrr additionat 1500 s0
Renewable Elec. EneEy: sKVA System or less
Thermostat (Noter $5 fur each additional)
_ Expiration Date
Phone: ]la; dlo '4DA
Ouantitv LOla! (Quantity x Charge)
$_
$
$
$
$
$
$
$
$
s
$
s
$
$
$
14{r'
$113.00
$s6.00
$_
$_t*OU-i l. I .'- toraL
owner as defined by RCW 19.28.261: (1) Owner will occupy lhe strusture for two years aftier this electrical permit is finalized. (2) Owner isrequired to hire an electrical contractor if above said property is for sale, rent or lease. permit expires afte; six months of last inspection
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electncal Contractor. I
am making the electrical installation or alteration in compliance with the electrical laws, n.e.c., Rcvri clapter 1g.28, wAc. chapter 296-468, The city of Port Angeles l\4unlcipal code, and Utjlity Specifications and PAMC 14.05.050 regarding ilectrical permit Applications_
Oate Print Name Signature (E Owner fl Electrical Contractor /Administrator)
FORMATION
lElectrical Permit Applications may be submitted to City Hall or epermits@cityoFa.us or faxed to 360.41|7 .47111
OWNER INFORMATION
$102.00
$121.00
$164.00
$185.00
$96.00
$88.00
$88.00
$96.00