HomeMy WebLinkAbout520 E Park AveELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-473s
18-00000104 Date 2/15/18
1174 8 0
520 E PARK AVE
06-30- 15- 5- 0 - 9160 - 2 001-
EI]ECTRICAI] ONITY
REPORT STATE SAI-ES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application Numloer
Applj.cation pin nudber
Propertsy Address
ASSESSOR PARCEL NUMBER:
Application tlpe description
Subdivision Name
Property Use
Property zoning
Application vafuaLion 0
Applicatsion desc
Ductless heat pumps x4
ST ANDREW I S RETfREMENT COMNTY
703 CALIJAHAN DR
BREI"IERTON wA 983103347
BLAC( DIAIV1OND ELECTRICAL CONTR
502 BLACK DIAMOND RD
PORT ANCELES WA 9435]
(350) 555 1035
Permit
ACdi t iona I desc
Issue Date
EIECTRICAL ALTER COMMERCIAI]
14 CIRCUITS
86.00 Plan Check Fee
2/t5/)B valuaL ioo
8/t4/a8Expirat.ion Date
Qty Unit Charge
00
0
BASE FEE
Extension
86.00
Charged Paid Credited Due
Permi! Fee Total
Plan Check Total
Grand ToEal
86.0C
.00
86.00
85.00
.00
85.00
.00
.00
.00
00
00
00
PERMIT WILL EXPIRE SIx (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
COMMENTS
Signature of owner or Electrical Contractor X Date:
N
Et!-lCrrvor Ponr Axcrr,ns Prnurr AppLrcATIoN
Building Division/Electrical Inspections
321 East Fifth Street - P.O. Box 1150 / Port Angeles \Yashington, 98362
Ph: Q60\ 4174735 Fax: (360) 417-4711
Date ,-[-- uutti.famity or Commercial*
- Plan Review May Be Required, Please Co Electrical Plan Review Information Sheet
Job AddEss
Building Sq!are Footage:
Descdptior of above
Ot rner lnlo
Name:
rmation<r Qars
[,4a]ling Address
Clty
ftem
Service/Feeder 200 Amp.
Se.vice/Feeder 201 400 Amp.
ServicdFeeder 401 $00 Amp
Service/Feeder 6011000 Amp.
ServicdFeeder over 1000 Amp.
BEnch Circuit W Seryice Feeder
Blanch Circuit WO Seruice Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Servicei Feeder 200 Amp.
Temp. Service/Feeder 201400 Amp.
Temp. ServiceFeeder 401$00 Amp.
Temp. SeryiceFeeder 601-1000 Arnp .
Portal to Portal Houiy
Sign/Outline Lighting
SignalCircuiU Limited Energy - lVulti-Family
SignalCircuiU Limited Enercy / First 1500 sf- Commercial
Nole: $5.0010r each additional 1500 sf
Renewable Electrical Energy - sKVA System or Less
Themoslat
Nole: $5.00 for each additionalTstat
Contraclor lnformation
Name Rr lr(
Ma ing Address:Statei Zip:Phooe: Fax:
License {/ Exo._
Ciiy:Statei _ zip: _
Phone
License d / Exp
Total (ftY MultiDlUnit Charqe
$ 132.00
s 160.00
$ 225.00
$ 288.00
$ 410.00
bv Unit Charqe)
q
s
s
5.00
74.00
500
86.00
102.00
121.00
164.00
185.00
$
$
$
$
$
$
$
$
$
$
$
$
s
sC 'rni*:
$
$
q
$
s96.00
88.00
64.00
96.00
s
g
q
$ 113.00
$ 56.00
s
S
^, oo
$ W:-]tot"r
owner as defined by RCW.'19.28.261: (1) owtter will occupy the structure for t\ ir years after this electrical permit is finalized. (2) Owner is required
to hire an electrical mntractor 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 propedy 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 Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Signature of owner, electdcal contractororelectrical administrator:
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