HomeMy WebLinkAbout1115 W 11th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
18 00000973 DaEe 6/27 /18
914966
1115 W 11TH ST
0 5 - 3 0 - 0 0 - 0 - 3 - 1 7 8 0 0000-
ELECTRICAL ONI]Y
RS? RESDNTL SINGLE FA.I4I LY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
qc
-sJ
'a\\
Application Number
ApplicaLion pin nunicer
Property Address
ASSESSOR PARCEL NUMBER:
ApplicaLion tl.pe description
Subdivision Name
Property Use
Property Zoning
Application valuation
ApplicaEion desc
DucLles s heat pump
CCMJR ENTERPRISES
112 CHARLES WAY
SEQUIM
(350) 583 3457
LLC
wA 98382
BLACK DIAIIOND EIJECTRICAL CONTR
502 BLACK DIAI4OND RD
PORT ANGEI,ES WA 98363
(360) 555-1035
Permit
Addilional desc
Permits Eee
Issue DaEe
Expiration Date
63-00
6/2i/18
t2/24/aa
EI,ECTRICAT ALTER RESIDENTIAL
PIan Check Fee
Valuation
00
0
Qty Unit Charge Per
1,OO 53,OOOO ECII EL-R- BRANCH CIR Wo/ SER FEED
Ertension
53.00
Charged Paid CrediEed Due
Permit Fee Total
Plan check Total
Grand Total
63.00
.00
63.00
63.00
.00
63.00
00
00
00
INSPECTION Tl?E DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
COMMENTS:AY
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature ofowner or Electrical Contractor X Date:
.00
.00
.00
1 - 2 SINGLE-FAMILY
AL PERMITAPPLICATIO
1'o
=ELECT
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
3 60.4 17 .47 3 5 i www.c ityofpa.us I electricalpermits@cityofu a
/ I t9 ,n7 // 7P/
6
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VProject Address
Project Description buc.ru.Sr #/
ngle-Family Residential D Duplex / ARU Building Square footage
Mailing Address
Email
Phone )ao' 'tgt- lgr
Name License
lvlailing Address
Email:
5b2- D Lr.c(/- Dlu|6--,, Z, Expiration Date
Phone: 36a:t- 3q 17
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 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 201400 Amp.
Temp. Service/Feeder 401€00 Amp.
Temp. Service/Feeder 601-1 000 Amp.
Portal to Portal Hourly
Signal Circuivlimited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
Date Print Name
[Electrical Permit Applications may
Unit Charoe
$120.00
$146.00
$205.00
$262.00
$373 00
$5.00
$63.00
$5.00
$75.00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
Quantitv fglEl (Quantity x Unit Charge)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
TOTAL
Owner as defined by RCW 19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is
required to hire an electrical contractor if above said prcperty is for sale, rent or lease. Permit expires after 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 electrical contractor I
am making the electrical installation or alteration in compliance with the e cal laws, N.E.C., RCW Chapter 19.28, WAC. Chapter 296-
46B, The City of Port Angeles l\runicipal Code, and Utility S nd PAMC 14.05.050 regarding Electrical Permit Applications.a
ature Owner I Electrical Contractor / Administrator)
be submitted to City Ha o r elect lpermits@cityofpa. us or faxed to 360.417.471'1I
I
IUN 2
Name:
ELECTRICAL.CONTRACTOR NFORMATION