HomeMy WebLinkAbout1020 W 14th StApplication Number
Applicat.ion pin [umber
Property Address
ASSESSOR PARCEL NI]MBER:
ApplicaEion type description
Subdivision Name -
Property use
Property Zoning
Applicatio valuatsion
19- 000011?5 Date 8/o"l /79
882000
1020 w 14TH ST
06-3 0 -00 - 0-4 - 1315 - 0000-
ELECTRICAI ONLY
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4t7 -413s
RS7 RESDNTI, SINGI,E I'AMII,Y
0
REPORT STATE STLES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Applicatlon desc
Service repair
Co tsractsor
LEAH .] ERB
839 W 6TH ST
PORT ANGEI,ES wA 983 53
SIMPSON EIJECTRIC
243 03 6 W rVry 101
PORT ANGELES
136At 4s7 -92'7a
wA 98353
Permit
Additional desc
Perm1t lee -
Issue Date
Expiration Date
120 .00
B/07/t9
2/03/20
EIECTRICAL ALTER RESIDENTIAL
00
Qty Unit Charge Per
1.00 120 .0000 EcH
.00 63.0000 ECH
E!-O-2OO SRV FEEDER
E!-R- BRANCH CIR WO/ SER FEED
Charged Paid Credited Due
Permit Fee ToEal
PIan Check Tctsal
Grand ToEal
120.00
.00
120. 00
120
120
00
00
00
00
00
00
o0
o0
o0
PERMIT W1LL E)(?IRE SIX (6) MONTHS FROM I-A.ST INSPECTION
INSPECTION TYPE DATE:RESULTS INSPECTOR:
DITCH
SERVICE shln sr M
ROUGH.IN o
FINAL eh hz ,t s
COMMENTS:
Signa ture ofowner or Electrical Contractor X Date:
Plan Check Fee
Valuation 0
Extension
120.00
.00
1-2SING LE-FAMILY
ELECTRI C AL PERMIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street. Port Angeles, \[A 98.162
-160.4 I 7.471-s I wrvr.r,.citvofpa.us I elcctricalpcnnits*4tciryofpa.us
PEc€rrr,.,
tu| - 6 2;;--5J
^.1\NProject Address 1020 W 14th St Port Angeles, WA 98363
Project Descript ion. Damaged mast
Name Lea Erb Email
Mailing Address 1020 W 14th Sl P hone
Name S rnpson E ectric LLC License SIMPSELST3RQ
Exp iration Date: 1211112019
Phone
Mailing
Email:
Address: P O. Box 1086 Port Angeles, WA 98362
Item
Service/Feeder 200 Amp.
Service/Feeder 201 -400 Amp.
Service/Feeder 401 600 Amp.
Service/Feeder 60'1-1000 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 401-600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Signal CircuavLimited Energy - 1&2 DU.
Manufactured Home Conneclion
Renewable Elec. Energy: sKVA System or l6ss
Thermostat (Note: $5 for each additional)
Unil Charoo
$120.00
$146.00
$20s.00
s262.OO
$373.00
$s.00
$63.00
$5.00
$75 00
$93.00
$110 00
$149.00
$168.00
$96.00
$64 00
$120.00
$102.00
$56.00
Ouantitv fglat (Ouanrity x Unit Charge)
120.00$
$
$
$
$
$
$
$
D
$
$
$
$
$
I
$
$
1
$74.00
$110.00
TOTA L s 120.00
Owner as defined by RCW 19.28.261: (1) Owner will occupy the structure for two years after thas electrical permit is finalized. (2) Owner is
required to hire an eleckical 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 contractor. 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 Port Angeles Municipal Code, and Utility Specifacations and PAMC 14.05.050 regarding Electrical Permit Applications.
8lOOl2019 Andrew P Simpson 4ntz.ot,
Date Print Name Signature (fl Owner p Electrical Cont /Administrato0
First 1300 Square Feet
Each Additional 500 squars feet"
Each Outbuilding / Detached Garage
Each Swimming Pool / Hot Tub
IElectrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa. us or faxed to 360.417.47111
1lo
=
+t
E Single-Family Residential ! Duplex / ARU Building Square footage: _
OWNER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
PROJECT DETAILS
$_