HomeMy WebLinkAbout217 E 11th StELECTRICAL PERMIT
CMY OF PORT ANGELES
360-417-4735
RS? RESDNTL SINGLE FA]UILY
0
REPORT STATE SAIES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Appficaeion Number
Applicatsion pin number
Property Address
ASSESSOR PARCEL NUMBER:
ApplicaEion ty,pe description
subdivision Name .
Property use
Property zoniog
Applica!ion valuation
19 - OO0O1O10 Dare 7/03/19
6A6270
o5 -3 0 - 00 - 0 -3 -2965- 0000 -
EIJECTRICA! ONLY
Application desc
service and circuits
O&'oer ContracEor
IIANKINS, ASHLEY
13 71 ] CRABS RD
SEQU]M
EXTRA MII,E TECH
418 N. RACE ST.
PORT ANGELES(360) 457 -5222
& ELECT., LLC
wA 98362wA 983 82
Additional
Issue DaEe
Expiration
desc
Date
145 .00
7/03/19
a2/3a/19
Plan Check Fee
Valuation
ELECTRICAI, ALTER RESTDENTTA],
0
oty units Charge Per5.00 5 .0000 EcH EL-
1.00 120.0000 EcH EL-
BRANCI,I CIRCUIT W/I.EEDER
O 2OO SRV FEEDER
ExLension
2s .00
120 .00
Charged Pa id Credited Due
Permic Fee Totsaf
Plan Check TotsaI
Grand ToEaf
145 .00
.00
145.00
00
00
00
145
145
W V'tdo>cgc-o )
PERMM WILL EXPTRE SIX (6) MONTHS FROM LAST INSPECTTON
INSPECTION T\?E DATE:RESULTS:
SERVICE "1"i8-t?t?M
ROUGH-IN '7- lR-.1?,lk'P
FINAL tLlr ln -F
S ignature of owner or Electrical Conkactor X Date
-s
o
o
.00
.00
. o0
. o0
.00
.00
.00
INSPECTOR:
DITCH
@
COMMENTS:
!anr
APPHOVED
ELECTRICAL INSPECTION
WIRING REPOHT
417-4735
NOT APPROVED
DITCH tr
n
tr
r
n
tr
D . . FINAL A=
NOTIFY IN$PECTOR WHEN CORRECTIONS
AEE COMPLETED wlTHIN 15 OAYS
_ OO HOT REMOVE_
OATE:
I . w1D
NSPECTOF
COIJTBACTOR
ADDBESS
H*
....,.-ROUGH|N/COVER
. , . SEHVICE
coRnEct"toNs NEEDEo. 3 +noxE * rz-e.___i. bTl doPr? rr.ll"
1-2SING LE-FAMILY
ELECTRICAL PERMIT APPLICATION
Public Works and Utiiities Departrnent
321 E.sth Skeet, PortAngeles, WA 98362
360.41 7.473 5 | rvwrv.cityofo a.us I electricalpermis@cityofpa.us
RECEIVED
JUL -/ 2U9
Phone:z4tz - 57 7 -Azo 3
!o
3
!?
-o\
o
vde""*Proiect Address:
,1
Name:
at1 e i /tL
a-,"aJ
Email.
Mailing Address'
Name:LE Te
S.f..
t:rx}rlF€:EXtRt*fif ?73 P I
bL Expirafon Dab:t2-zO - Zon
Phon€:4Lo -'lt l-t 338
Malling Addr€ss.o.o* 3lf8
Email:
irea-
th
ServicE/Fge(,rr 200 Arp-
S€Ivice/Feedsf 20f 400 Anp.
SeNice/Fe€der 401€@ Anp
SeMG/Feeder ml-10@ Amp.
ServicerFeedg ouer I 000 Amp.
Btancft CLcuit tM Se'ri'c! Fcsd.t
Btandr Cic1rit t\rlo Sefliee Fesder
Esch Addional Branch Glqrt
Branch CLqJib 1-+
Temp- ServiE Fe€der 200 Afip-
Tcmp ServicdFeoder 201.{00 A'II,.
TelBr. S€rvicerFe€dlr i|{}16(x, Arp-
Tenp- Ser$cerFeeder $l-t0@ Amp
Po.tal to Portll Ho{rly
Signd CiElit/LirfEd Emrfy - 1e2 Ofr.
ManutadJrBd HryrE CGrn..tro.r
Remryebb Elec En€rgy: SKVASysEm or le3s
Thermffit (No{e: t5 breadt a.ldfioml)
Frd 13flt Sqrrs Fsd
.. E ah^.ffrold 6@!qJgtE td'
. Edrqtrbrr&tg, DeHld cst3
Esdr Sriifirfi€ F6t, Hot nb
Unit Charo"
sl20.00
$146.00
$205.00
$262.m
$373.00
$5.00
$4.00
$5.00
$75.0O
$93 00
$r10.00
8t4S.00
$168.0O
$96.00
s64_00
$120.m
$102.@
s56.00
8120.&)
g{100
5r4.m
31r0.00
Ouantltu
,
5
=TOTAL
lQhl (Qrlnlry r Unft Chrrge)
,/ 2.o ,..
^5'o
-;??-,-
$
U
$
$
$
$
I
r!
I
$
J
$t
$
$
$
$
$
$
s
$
3
3
Ou,ner as defmed by RCt 119-28-26't: (1) Ow'terwilloc@py the sfudure fo. trxo yeaE aflarlhb etectrical lBrmit b fina,iz.d- (2) O^,ner braquiEd to hirB an ele(fhal colbrdor if abo\re saii pqetty is for S3h. rBr{ or l€ase- Pa'rnit epires afler sk mor{hs of last iolpedbn-
At€r reading t re above siabmeld' I hcreby certify that I am tie o\ rner of the above na.rEd popedy ora licenled elecfical cont-actor. I
am making lhe electriral instBllalion or stteEtion in conplance wifl tte ele(trr'cal lavl3, N-E.c-, Rcw. chaB 1928, !tAC. Chapbr2gS
468, The City ot Port and PAMC 14.05.050 regarding Electicd Permit Applications_'-7 *s* L
Date Print Name Sigmaturc (E Oi,ner Cont'ador / Admirftfator)
ArEder t uak pd Code, and lrfdy Spqindionst f.-* 3rr
lElectrical Permit Applications may be submitbd to o.ty Ha[ or elecfricalpermib@cityoFa us or faxed to 360 -417 .41 11)
El Dupbx /ARU Budding SquarE b&ge: