HomeMy WebLinkAbout200 W 1st St (3)ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -473s
CENTRAL BUSINESS DISTRICT
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Pori Angeles
(Location Code 0502)
3
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Applicatsion Nun&er
Application pin number
Property Address
ASSESSOR PARCEL NTIVIBER:
Application t')?e description
Subdivision Name
Property Use
Property zoning
Application valuation
19- 00001655 Date t0 /25/t9
165755
200 w 1sT sT
06-3 0- 00 -0- 0 - 3 300 - 0000-
ENECTRTCA], ONLY
Application desc
Deli Lights
JOHN,] & ROBIN K MILETICH
312 RED DEER DR
PORT ANGEIES WA 98362
/'350) 452-'71-75
S]MPSON ELECTRIC
243036 W HWY 101
PORT ANGELES
136A) 451-927 0
Permit
Additional
Pemit Fee
Tssue Datse
ELECTRICAL AITER COMMERCTAI
1-4 CIRCUITS
85. O0 Plan Check Eee
-10 /25 / 19 vafuar.ion
4/22/20
00
0
ExpiraEion Date
Qty Unit Charge Per
BASE FEE
Charged Paid credited Due
PermlE !ee ]'ota1
PIan Check Total
86. 00
- 00
85. 00
85.00
.00
85.00
00
00
00
o0
o0
o0
PERMTT WILL EXPIRE SD( (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
ROUGH-IN nlzs/tq I w42
FINAL A[hln 4
COMMENTS:
Date
wa 98363
Extsension
85.00
SERVICE
JY-
Signature of owner or Electdcal Conkactor X
IMULTI-FAIVILY /COMTUERCIAL
ELECTRICAL PER MIT APPLICATION
Pr"rblic l4rorks and Lltilities Deparlment
::1 E- 51h SLleei. Fort.\nseles. \\A 98.162
-160,.1i7."j71-l I r.r,rvrv-c ir_volti: -i I s ciccrrital;:crmits,.rhciry,lflta_us
Project Address Country Aire Natural Foods 200 W 1st St. Port An geles, Wa 98362
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Project Descdption Alterino 2 circuits in the deli for li qhts
I lvlulti-Family Residential E Commerciat / lndustrial / pubtic Building Square footage
Name John [riletich Email
Mailing Address 312 Red Deer Dr phone 360-457-9348
Name: Simpson Electric LLC liss6s6 SlMPSEL9T3RQ
[/ailing Address P.O. Box 1086 Expiration Date 1211112021
Email dlsim il.com Phens 360-457-9270
Item Unit Charoe it Charge)
Service/Feeder 200Amp.
Service/Feeder 201 -400 Amp.
Service/Feeder 401 -600 Amp.
Service/Feeder 601-'l 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 40'1-600 Amp.
Temp. Service/Feeder 601-1000 Amp
Portal to Portal Hourly
Srgn / Outline Lighting
Signal CircuiVLimited Energy. yx111-5"r,',
Srgnal CircuiVLimited Energy/First 15OO sf - Commercial
(Note: $5.00 for each additional 1500 sf)
Re'rewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 tor each additional)
$88.00
10t23t2019 Andrew P Simpson ,1"4r.a, p
Print Name Signature (E Owner p Electri Conlractor / Administrator)
) ]JZ UU
$'60 00
$225 00
$288.00
$410.00
$5.00
$74 00
$5.00
$86.00 1-4
$ 102.00
$'21 00
$164 00
$'85 00
$96 oO
$88.00
$96.00
$113.00
$56.00
IElectrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa. us or faxed to 360.417.4711]
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$8600
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$ 86.00 rorAL
Owner as defined by RCW 19 28.26'1: (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 of the above named property or a licensed electrical contracto. I
am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW Chapter 19.28, WAC. Chapter 296-
468, The City of PortAngeles lvlunicipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical permit Applications.
Date