HomeMy WebLinkAbout129 W Park AveELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -4135
RS7 RESDNTL SINGLE FAMTI,Y
0
REPORT STATE SALES IAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application Nuniber -
Application pin nullber
Property Address
ASSESSOR PARCEL NUIV1BER:
Application E)?e descript.ion
subdivision Name
Property Use
Property Zofling
Application valuation
19- 00001236 Datse 8/1-5/1-9
381592
129 W PARK AlE
06-3 0- 09- 5 - 2 -3657 - 0000-
ELECTRICAL ONLY
Application desc
DI]P
Ovr'ner
TRACY ALLEN
129 W PARK AVE
PORT ANGEI,ES
(360) 417-3713
BI,ACK DIAMOND EIJECTRICAL CONTR
502 BI.ACK DIAMOND I'D
PORT ANGEIES WA 983 53
1350) 565-1035
wA 983 52
Permit
Additsionaf desc
Permits Fee
Issue Datse
Expiration DaEe
53.00
B/ls/le
2/lr/2a
ELECTRICAL AITER RESIDENTIAL
00
0
Qty Unit Charge
1.00 63.0000
Per
ECH EL-R- BRANCII CIR WOl SER FEED
Extension
63.00
Fee summary Charged Paid Credil:ed Due
63 .00
.00
53 .00
.00
- 00
.00
.00
.00
.00
PERMTT WILL EXPIRE Stx (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
ROUGH.IN alzr, ). o w @Y
FINAL alzt ln R ffi
COMMENTS:
Signature of owner or Electrical Contractor X Date
Valuatsion
Permit Fee Total
Plan Check Total
Grand Total
63.00
.00
53 .00
SERVICE
ET 1.2 SFLL
ELECTRICAL PERM IT APPLICATION
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Public Works and Utilities Departrnent ff:,7i;i
12l
360.417.4735
l. 5th Strect. Pon Angeles, WA 98362
www.cityofpa.us I electricalpermits@cityotpa.us
POect Address:129 W Park
Project Description:Add circ for ductless
OWNER INFORMATION
1.12m9; Allan Email
Mailing 6661s55. 129 W Park p6ens. 36H61-5342
ELECTRICAL CONTRACTOR INFORMATION
lrlsrns; Black Diamond Electrical License: 9LACKEC894D2
Expiration Date
Phone:
Mailing Address
Email:
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 20 1 -400 Amp.
Service/Feeder 401-600 Amp.
Service/Feeder 601-1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuat
Branch Circuits 1-4
Temp, Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 40'1400 Amp.
Temp. Service/Feeder 601 -'l 000 Amp.
Portal to Portal Houdy
Signal CircuiVLimited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: SKVA System or less
Thermostat (Note: $5 ior each additional)
First 1300 Square Feel
Each Additional 5OO square feet''
Each Outbuilding / Detached Garage
Each SwimmirE Pool / Hot Tub
lJnil Charoe
$'r20.00
$'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
$40.0o
574.00
$110.00
Ouantitv Ighl (Quantity x Unlt Charg€)
1 63
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Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years affer this electrical permit is finalized. (2) Owner is
required lo 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 contractor I
am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter '19.28, WAC. Chapler 296-
468, The City of Port Angeles Municipal Code, and Utility Specilications and PAMC 14.05.050 regarding Electrical Permit Applications.
B-z-2oie Benjamin Sham p
Date Print Name Sigoature (El Oamer I Elechical Contractor /Administrator)
[Electrical Permit Applications may be submitted to City Hallor electricalpermits@cityofpa.us or faxed to 360.417.47111
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1 - 2 SINGLE-FAMILY
tr Single-Family Residential E Duplex / ARU Building Square footage:
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