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AppLicaE j.on pin nudber
Propelty Address
ASSESSOR PARCEL NT'},IBER :
Application, type description
Subdivi.si.on Name . -
Propelty Use
Propercy zoning
Application valuation
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RS7 RESDIITL SINGLE FA}'IILY
0
18 - OOOO1?84 Date 12113/18
945392
1614 E 3RD ST
06-30- 00- 6- 9- 0410 - 0000 -
ELECTRICA]. ONI,Y
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
do
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Applicatlor! desc
Ductlegs heat pump
Contractor
]RIDAI,E ROBIN/(ATHY
1614 E'3RD ST
PORT ANGELES
BI,ACK DIAMOND ELECTRICAL CONTR
502 BIACK DIP,MOND RD
PORT ANGELES WA 983 63
(350) s6s-1035
wA 983624805
Permi!
Additional desc
Permit Fee
fssue Date
ExpiraEion Date
63 .00
t2/1-3/t8
6/L!/19
EIECTRICAL AITER RESIDENTIAL
Plan Check Fee
valuation
.00
0
QEy UniE Charge Per
1.OO 53.OOOO ECH EL-&- BRANCT{ CrR WO/ SER FEED
ExEension
63 .00
charged Paid CrediEed Due
Permil Pee Tot'al
Plan cbeck Total
Grand Total
63 .00
.00
53.00
63.00
.00
53 .00
.00
.00
.00
.00
.00
.00
PERMIT WILL EXPIRE SIx (6) MONTHS FROM LAST NSPECTTON
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
COMMENTST Til<
Signature of owner or Eleclrical Contractor X Date:
ELl-2 sF
ELECTRICAL PERMITAPPLICATION {O1/'
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 www.cityofpa.us I electricalpermits@cityofta.us
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tion b,-x.t-v,5JProject Descrip
{qngte-ram ily Residential ! Duplex / ARU Building Square footage
OWNER INFORMATION
h+-txr-c-Email
Mailing Address tLll e- 3,q pnone: 60 j - oo /o
ELECTRICAL CONTRACTOR INFORMATION
t-License
Expiration Date
Phone; |Lo --%mlvlailing Address:
Email:
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 40'l 600 Amp.
Service/Feeder 601 -'l 000 Amp.
Service/Feeder ove|l 00O Amp.
Branch Circuit W Service Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuil
Brandr Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Srgnal CircuruLrmited Energy -'l&2 DU.
Manufaclured Home Conneclion
Renewable Elec. Energy: sKVA Syslem or less
Thermostat (Note: $5 for each additional)
First 1300 Square Feet
Each Addilional 500 square feet"
Eacfi Oubuilding / Detac*Ed Garage
Each Swimming Pool / Hot Tub
Ouantitv Iqtr! (Quantity x Unit Charge)
TOTAL
Owner as defined by RCW 19.28.261 (1)Ownerwilloccupythe structure for two years afterthis electrical permit is finalized. (2)Owneris
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 lam th of the above named property or a licensed electrical contractor I
electrical laws, N E C., RCW. Chapter 19.28, WAC. Chapter 296-am making the electrical installation or alteration in complian
468, The City of PortAnge unicipal Code, and U ns and PAMC 14.05.050 regarding Electrical Permat Applications
Date Print Name Signature Owner E Electrical Contractor / Administrator)
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
$120.00
$40.00
$74.00
$110.00
$
$
$
$
U
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
[Electrical Permit Applications may be subm to City Hall or epermits@cityofpa.us or faxed lo 360.417 .4711)
1 - 2 SINGLE-FAMILY
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