HomeMy WebLinkAbout925 Bryson AveELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-473s
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Application Nuflrber
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Appf ication. tsype description
sulrdivision Name
Property Use
Property zoning
ApplicaEion valuaEiorl .
18 - 000018 84 Date
235976
925 BRYSON Al,E
o6 -3 0 - 10- 5 - 1- 0155 - 0000 -
ELECTRICAI ONLY
REPORT STATE S,ALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
t2/L3/78
RS7 RESDNTL SINGLE FA,I4IIJY
o
ApplicaEion desc
DucEfess heaE pump
ContracEor
SHORT, LOUANN M
925 E BRYSON AVE
PORT ANCELES
BLACK DIA.I4OIJD ELECTRICAI CONTR
502 BI,ACK DIAMOND R!
PORT IlIIGELES TiA 98363
{360) s55-103s
wA 98352
Permits
Additsional desc
Per-nrlE Eee
Issue Datse
Expiration Date
63.00
12 /a3 / t8
6/aa/19
EI-ECTRICAL AI,TER RESIDENTIAL
00
oEv
1.00
Unit Charge Per
53.OOOO ECH EL-R- BRANCH cIR wo/ SER FEED
Extension
63 .00
Charged Paid CrediEed Due
Permit Eee Total
Pl.an Check Total
crand Totsal
63 .00
.00
53 .00
53.00
.00
53 .00
00
00
oo
o0
00
o0
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN
FINAL
COMMENTS EX
PERMTT WILL EXPTRE StX (6) MONTHS FROM LAST TNSPECTION
Signature of owner or Electrical Cofltractor X Date:
PIan Check Fee
vafuatsion 0
ELECTRICAL PERMIT APPLICATI
Pubiic Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.47 35 www.cityofpa.us electricalpermits@cityo
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Project Address
Project Description E v<a1Jv-t /
E Single-Family Residential n Duplex / ARU Building Square footage
O\^NER INFORMATION
Name LL,U-t-c-(<EJL Email
Phone o oMailing Address
ELECTRICAL CONTRACTOR INFORMATION
Name License:
Mailing Address
Email:
Expiration Date
Phone
Item
Service/Feeder 200 Amp.
Service/Feeder 201{00 Amp.
Service/Feeder 40'1 -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 201-400 Amp
Temp. Service/Feeder 401$00 Amp.
Temp. Service/Feeder 601 -'1 000 Amp
Portal to Portal Houdy
Signal Circuiulimited Energy - 1&2 DU
lranufactured Home Connection
Renewable Elec Energy 5KVA Sysiem or less
Thermostat (Note $5 for each addrtronal)
First 1300 Square Feet
Each Additjonal 500 square feet '
Each Outbuilding / Detached Garage
Each Swimming Pool / Hot Tub
7.(./-lt
Date Print Name
[Electrical Permit Applications may be
Unit Gharoe
$120.00
$146.00
$205.00
$262.00
$373.00
$s.00
$53.00
$5.00
$75.00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
$r20.00
$40.00
$74.00
$110.00
Ouantitv fgE! (Quantity x Unit Charge)
$
$
$
$
$
$
$
s
$
$
$
$
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$
$
$
$
$
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$TOTAL
Owneras defined by RCW19.28.261 ('t ) 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 properly is for sale, rent or lease. Permit expires after six months of last inspection
After reading the above statement, I hereby c€rtiiy that lam the of the above named property or a licensed electrical contractor. I
electrical laws, N.E.C., RCW Chapter 19.28, WAC. Chapter296-am making the electrical installation or alteration in compliance
458, The City of Port Ang sM cipal Code, and ns and PAMC 14.05.050 regarding Electrical Permit Applications
ignatu re Owner ! Electrical Contractor / Administrator)
PROJECT DETAILS
mitted to City Hall or epermits@cityofpa.us or faxed to 360.417 .4711)
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1 - 2 SINGLE-FAMILY
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