HomeMy WebLinkAbout1203 Campbell AveELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4t7-4735
RESIDENAIAI !iIGH DENSITY
0
.$
\\
Application Number
Application pin nuriber
Property Address
ASSESSOR PARCEI, NUMBER:
Application t!?e description
Subdivision Name
Property Use
Propertsy Zoning
Application valuation
19- 00 001316 Dare 8/2'7 /1-9
642420
12 03 CA}IPBELL A\,'E
06- I O - 14 - 5 - 3 - 0:] 4 0 - O00 0 -
ELECTRICA! ON],Y
Application desc
Underground services for all buildings
DON NIVENS
PO BOX 212
SEQU]M r{A 983 82
UPPER I,EFT EIECTRTC L1,C
13 05 ROOK DR
PORT ANGEI,ES WA 983 62
\36O) 461-1"120
Permi L
Additional desc
Permit Eee
Issue Date
Expiration Dale
96.00
8/27/19
2/23/2a
ELECTRICAL NEW RESIDEIITIAI
00
0
Qty UniE Charge Per
1.OO 96.OOOO ECH EI! TRIP FEE-INSPECT EX. INSTAL
Extension
95. 00
Fee summar:y Charged Pa id Credited Due
95. 00
.00
95.00
96.00
.00
95 .00
00
00
00
00
00
00
REPORT STATE SATES TAX
on your excise tax form
to the City of Poft Angeles
(Location Code 0502)
INSPECTION TYPE DATE INSPECTOR:
DITCH zlnln +P "ei$
SER\'ICE
ROUGH.IN
FINAL slz,\'ln R w
COMMENTS
PERMTN WILL EXPIRE SIx (6) MONTHS FROM I.\ST INSPECTION
PIan Check Fee
valuation
Permit Fee Total
Plan Check Totsal
Grand ToEal
RESULTS:
Signature of owner or Eleatrioal Contractor X Date:
ELr-2 sF 1-2 SINGLE-FAMILY
ELECTRICAL PER MIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, \[A 98362
360.4 17.4735 www.cityofpa.us 1 electricalpermits@cityofpa.us
A "rg-
no
=
if,i!,?:--DI
\l-.-D.Project Address
Project Description f o{
O!\NER INFORMATION
Name Email.
lvlailing Address:Phone
Name:
lvlailing
Email;
Address
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 Amp.
Service/Feeder 401€00 Amp.
Service/Feeder 601 -1 000 tunp.
Service/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit W/O 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. SeNic€/Feeder 601-1000 Amp.
Portal to Portal Hourly
Signal CircuruLrmited Energy - 1&2 DU
Manufactured Home Con nection
Renewable Elec. Energy; sKVA System or less
Thermostat (Note: $5 for each additional)
First 1300 Square Feet
Each Additional 500 square feet '
Each Outbuilding / Detached Garage
Each Swimming Pool / Hot Tub
a
License
Expiration Date
Phone:
Ouantitv Total (Ouantitv x lJnit Charoe)Unit Charoe
$120.00
$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
$56.00
$120.00
$40.00
$74.00
$110.00
\
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$TOTAL qa o c)
Owner as defined by RCW 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 certiry that I am the owner of the above named property or a lic€nsed electncal 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 Municrpal Code, and Utility Specifications and PAMC '14.05.050 regarding Electncal Permit Applications.
lZ1 ltZ e a",, P-.*-, ,7n -t r / Administrator)
ELECTRICAL CONTRACTOR INFORMATION
PROJECT DETAILS
8,
lElectrical Permit Applications may be submitted to City Hall or epermits@cityofpa us or faxed to 360.417.471'll
E Single-Family Residential n Duplex / ARU Building Square footage: _
1-2 ILY
ELE CTRICAL PERMIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
3 60 -4 17 .47 3 5 wlr"w.ciryofpa.us i electricalperm its@c ityofpa.us
;fti;;,
To
3
F
["
\Project Address lToZ C,r-,.nnbo.t( at,to
Prolect Description <=<-
Name Email
l\ilailing Address:Phone
ELECTRICAL CONTRACTOR I NFORMATION
Name:
Nila iling
Email:
Address
Item
Service/Feeder 200 Amp.
Service/Feeder 201{00 Amp.
Service/Feeder 401600 Amp.
Servicei Feeder 601-1000 Amp.
Servic€/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits 14
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401S00 Amp.
Temp. Service/Feeder 601-1 000 Amp.
Portal to Portal Hourly
Signal CircuivLimited Energy -'l&2 OU.
Manufactured Home Conneclion
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
First '1300 Square Feet
Each Additional 500 square feet"
Each Outbuilding / Detached carage
Each Swimming Pool / Hot Tub
License
Expiration Date
Phone:
Ouantitv l_qta! (Quantity x Unit Charge)Unit Charqe
$120.00
$146.00
$20s.00
$262.00
$373.00
$5.00
$63.00
$5.00
$7s.00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
$120.00
$aooo
$74.00
$110.00
47 r-,,,t
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$rorAL s 17.r,€;
Owner as defined by RCW 19.28.261: (1) Owner will occupy the structure for tlvo years afier this electrical permit is finalized. (2) Owner is
required to hire an electric€l 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 certjfy 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-
46B The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
PROJECT DETAILS
E
E Single-Family Residential E Duplex / ARU Building Square footage: _
OIINER TNFORMATION
lZl I t4 (--...'eQotse -z:>()bate "f Print Name si@r /Administrator)
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417 .47111