HomeMy WebLinkAbout425 E 5th StApplj.cation Nufiiber
Applicatsion pin number
Propert.y Addless
ASSESSOR PARCEI NUT4BER:
Appl. j.caEion t)?e description
Subdivision Nane .
Property use
Propetty ZoDing
Application valuatiorr
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
18 - 000 00557 Date 5/01/LA
252L82
425 E sTH ST
06 - 3 0 - 00 - 0 - 1- 716 0 - 0 0 00 -
ELECTRICAI. ONI,Y
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application desc
Ductless heat pump
Owne r Contractor
RAY T/JUDITH CHRISTIANSEN ?RST
159 HILLTOP DR # 2
SEQUIM WA 983829319
BI,ACK DIAMON'D ELECTRICAIJ CONTR
502 BIJACK DIAMOND RD
PORT ANGELES WA 98363
(350) s65-1035
Per:mi t
Addit.ional desc
Pelmrt Eee
Issue DaLe .
Expiration Date
ELECTRlCAIJ AI]TER RESIDENTIAIJ
14 CIRCUITS
75.00 Plan Check Fee
5/0L/ LB Val uaEion
ro / 2B /L8
00
0
Qty Unit Charge Per
BASE F'EE
Extension
75.00
Charged Credired Due
Permi t Fee Total
Plan Check Total
Grand ToEaI
?5. 00
.00
?5. 00
75.00
.00
75.00
.00
.00
.00
00
00
00
INSPECTION TYPE DATE:RESULTS:
DITCH
SERVICE
ROUGH.IN
FINAL
COMMENTS:z\
PERMM WILL EXPTRE SIX (6) MONTHS FROM LAST INSPECTION
Signature ofowner or Electrical Contractor X Date
INSPECTOR:
ELECTRICAL PERM IT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, 'fiA 98362
360.417.4735 i www.cityoflpa.us I electricalpermits@cityofpa.us
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Prolect Address ?zs E 5'71 A +-B
TwcrtTnl'S
Name 1gra137tpt16a1 Email
l\ilailing Address 121 E €14 Phone:
Name bG
Mailing Address
Email:
.sbz- 6,-a,.a-p !,l4--{ aa
License: B a.H- l4.a qo r.-
Expiration Date
phone: 3bo -L/Ct-lq,-,
Item
Service/Feeder 200 Amp.
Service/Feeder 20'1 -400 Amp.
Servic€/Feeder 401 -600 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 20'1 -400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp. Service/Feeder 60'1 -'1 000 Amp.
Portalto Portal Hourly
Signal C rcuiulimited Energy - 1&2 DU.
lvlanufactured Home Connection
Renewable Elec Energy: sKVA 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 Charoe
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$s.00
$75.00
$93.00
$ 1'l 0.00
$'149.00
$168.00
$96 00
$64 00
$120.00
$102.00
$56.00
$120 00
$40.00
$74.00
$110.00
Ouantitv lg!g! (Quantity x Unit Charge)
TOTAL --?-
Owner as defined by RCW 19.28.261: (1) Owner will occupy the structure for two years after this elect.ical 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 certify that I am the owner of the above named property or a licensed electrical mntractor. I
am rraking the electrical installation or alteration n compliance rical laws, N E.C., RCW Chapter'19.28, WAC. Chapter296-
PAMC 14.05.050 regarding Electrical Permit Applications.468, The City of PortAng eles Munici palCode, and Util itv
L/- 26./8 ktpv
Print Name Si ature Owner ! Electrical Contractor / Administrator)
[Electrical Permit Applications may be submitted to ity Ha or electricalpermits@cityofpa. us or faxed to 360.417.47111
1 - 2 SINGLE-FAMILY
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Prolect Description:
E Single-Family Residential E Duplex /ARU Building Square footage:
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O\A/NIER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
PROJECT DETAILS
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