HomeMy WebLinkAbout1836 W 4th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RS? RESDNTL SINGLE FAMILY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application Nufirlcer
Application pin number
Property Address
ASSESSOR PARCEI, NU},IBER:
Application t)?e descripCion
Subdivision Name
Property Use
Property zoning
Appf ication valuat.ion
19 - 00001113 Date 7 /24/L9
509086
1836 W 4TH ST
06- 30- 00- 0- 1-44{5-0000-
EIJECTRICAI' ONI'Y
Applicatlon desc
Raise mast
Contractor
SHU ZEN ANDERSON
1816 W 4TH ST
PORT ANGELES
BOTERO & SON ELECTRICAI PLLC
PO SOX 702
CARLSBORG }IA 98324
(350) 461-9132
wA 943531706
Permit
Addit ional
Permit Fee
Issue Date
Expiration
desc
Date
120. O0
7 /24 / t9
L /20 /20
ELECTRICAL ALTER RESIDENTIAL
PLan check Fee
valuation
.00
0
Qty Urits Cllarge Per
1.00 120.0000 EcH EL-0-200 sRv FEEDER
Bxteusion
120.00
Fee summary Charged Paid credited Due
Permit Fee ?ota1
PIan Check lota1
Grand ToEal
120 .00
.00
120 .00
t20
!20
00
00
00
.00
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.00
.00
.00
.00
PERMTT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE 1-e- n JP
ROUGH-IN
FINAL q)z,a ln ,IF 'F+<
COMMENTS:
Signature of own or Eleotdcal Contractor X Date
t
*rs
1 - 2 SINGLE-FAMILY
ELECTRICAL PERM IT APPLI CATION
Public Works and Utilities Department
321 E. 5th Street, Pon Angeles, WA 98362
360.417.47 35 www.cityofpa.us I electricalpermits@cityolpa.us
RECEIVED
JUL t { l0l9
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\
\N(Project Address
Name
Mailin
Email:
Project Oescription
n Single-Family Residential E Duplex i ARU Building Square footage
Mailing Address
)
Email
P hone:
c<-License
Exparation Date:
Phone:
g Address
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401€00 Amp
Service/Feeder 601-1000 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 20'1400 Amp.
Temp. Service/Feeder 401600 Amp.
Temp. Service/Feeder 6011000 Amp
Portalto Portal Hourly
Signal CircuiULimated Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energyt sl(VA System or less
Thermostat (Note: $5 for each additional)
First 1300 Square Feet
Each Additional 500 square feet '
Each Oubuilding / Detached Garage
Each Swimming Pool / Hot Tub
Unit Charoe
$120.00
$146.00
$205.00
$262.00
$373.00
$s.00
863.00
$5.00
$75.00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
$120.00
$40.00
$74.00
$110.00
A|lrllis+-Total C harge)
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$
$
$
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$
$
$
$
$
$
$
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$
$
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$
$
$
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Owner as defined by BCW 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 ofthe above named property or a licensed electrical contractor. I
am making the electrical installation or alteration in complia I laws, N E C., RCW Chapter 19.28, WAC. Chapter 296-
468.Port un Code, and Utility S d 1 4.05.050 regarding Electrical Permit Applications.
4 a
Print Name ig Owner E Electrical Contractor / Administrator)
OWNER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
PROJECT DETAILS
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa. us or faxed to 360.417.47111
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Name:
Date
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ADDSESS
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ELECTRICAL INSPECTION
WIRING REPORT'
417-47.35
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NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WfTHIN 15 DAYS
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