HomeMy WebLinkAbout1735 W 6th St (2)ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4t7-4735
CS
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0-.
ApplicaEion Nu$lcer
Application pin number
Proper:ty Address
ASSESSOR PARCEL NUMBER I
ApplicaEion t)?e description
Subdivision Name
Property use
Property zoning
Applicaiion valuation
18 - 0 0001561 DaEe 1-0/L6/tB
976120
L735 W 6TH ST
06-30-00-o-1-4255 0000,
EIECTRICAT ONNY
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
UNT.IIOWN
Applicatioa desc
Ductsless heat pump
BLACK DIAMOND EI,ECTRICAL CONTR
502 BLACK D]AMOND RD
PORT ANGEI,ES WA 98363
(360) 565-1035
Permit
Addltsioral desc
Permit Fee
fssue Date
Expiration Date
63.00
aa/as/18
4/03/t9
Plan Check Eee
Valuation
ELECTRICAL AI,TER RESIDENTIAL
.00
0
Qty Unit Charge Per
1.OO 53.OOOO EcH EL R BRANCH CIR I,Iol sER FEBD
Paid Credited Due
63.00
.00
53.00
63.00
.00
63.00
00
00
00
00
00
00
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FiNAI-
COMMENTS:6.x-
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPBCTION
Signature of owner or Electrical Contractor X Date:
0
TINA GAI,LON AND KURT R LAUBENH
1735 !, 6th
PORT ANGELES WA 9A]62
(360) 808-9225
Extension
63.00
charged
PermiL Fee Totsa1
Plan Check Totsal
Grard ToEal
Er 1-2 SFLL 1 - 2 SINGLE-FAMILY
ELECTRICAL PERM IT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 www.cityofpa.us I electricalpermits@cityofpa.us
173 t- tr e n-
Prolect Address:
Project Description Fotc- f2g12 ,a '-.
! Single-Family Residential uplex / ARU Building Square footage
Name
i/ailing Address
Email
Phone 7L6 -al)z-392E
OWNER INFORMATION
ELECTRICAL CONTRACTOR I NFORMATION
Name tlat-License:
Expiratio
Phone:*t JLrTn DateMailing Address
Email:
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201 -400 Amp.
Service/Feeder 401600 Amp.
Service/Feeder 601-1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 1{
Temp. Service/Feeder 200 Amp.
Temp. Servicei Feeder 201-400 Amp.
Temp. Service/Feeder 401€00 Amp.
Temp. Service/Feeder 6011000 Amp.
Portal to Portal Houdy
Sgnal CircuiVLimited Energy - 1&2 DU.
Manufactured Home Conneclion
Renewable Elec. Energy: sKVA System or less
Thermostat (Note: $5 for each additional)
First '1300 Square Feet
Each Additional 500 squaro f6et''
Each Outbuilding / Detached Garage
Each Swimming Pool / Hot Tub
U[il.ciarse
$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
$s6.00
$120.00
$40.00
$74.00
$110.00
Ouantitv fqE! (Quantity x Unit Charge)
$
$
$
$
$
$
$
!
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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 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 the named property or a licensed elect.ical contractor I
am making the electrical installation or alteration in compla llaws, N.E.C , RCW Chapter 19.28, WAC. Chapter296-
468, The City of Port Angele tct Code. and Utal PAMC 14.05.050 regarding Electrical Permit Applications
/o-/z-r
Date Print Name
[Electrical Permit Applications may be su
s re Owner Electrical Contractor / Administrator)
m itted ity H ll or epe rmr ts@cityofpa us or faxed to 360.417 .471'11
(Jk uSL DLb ct#-crc- PaA Q
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