HomeMy WebLinkAbout2003 W 15th StApplicatsioo Nuniber . -Applicalion pin number
Property Address
ASSBSSOR PARCE! NU}IBER:
Application tl,'pe descripEion
Subdivision Name , .
Property Use
Property Zofling
ApplicaEior valuation . . .
19-0000132s Date A/29/t9
603850
2003 w 15?H ST
o6- 30- 00- 1- 0 -7505- 0000 -
EIJECTRICAL ONIY
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RESIDEI.ITIAL TRAILER PARI(
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Application desc
service
Owrer Contsractsor
JOHNETTA K BINDAS
2012 W 14m ST
PORT ANGELES
1350) 452-3127
BLAC( DIAMOND ELECTRICAL CON'I?
502 BI,ACK DIA,!'IOND RI)
PORT ANGELES WA 983 63
(360) s55 1035
wA 983535102
Permit , .
Additional desc
Permit Fee
Issue Date
Expiraf,ion Date
120 - 00
I /2e/Le
2 /25/20
ELECTRICA! ALTER RESfDENTIAL
Plan Check Fee
ValuaEion
00
0
Qty Unit Charge
1.00 120.0000 ECI{ E], O.2OO SRV FEEDER
Extenaion
120.00
Fee summary Charged Pald Creditsed Due
PenniL Fee fotal
P.lan cnecx toEaL
crand Total
120
120
. o0
.00
.00
120 .00
.00
120 .00
.00
.00
.00
.00
.00
.00
PERMTT WILL EXPIRE SIX (6) MONTHS FROM ["A,ST INSPECT1ON
INSPECTION T1?E DATE:RESULTS:INSPECTOR:
DITCH
SER\'ICE slx,lm dP d
ROUGH.IN
FINAL sl.aln {fr
COMMENTS:
I
TI
T
Signature of owrer or Electrical Contractor X Date:
*
1 - 2 SINGLE-FAMILY
ELECTRICAL PERIU IT APPLICATION RECEIVED
AU6 2I 2019
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3
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Project Address
Description:S0aultc-e R--t-Or-*<*.
Single-Family Residential n Duplex / ARU Building Square footage
n zao'J .-^/ , f Email
Mailing Address >Ekl r-.LbCrL Phone
ELECTRICAL CONTRACTOR IN FORMATION
Mailing Address
Email:
License
Expirati
Phone:
on Date
Iq!a! (Quantity x Unit Charge)lzo -
Item
Service/Feeder 200 Amp.
Servic€/Feeder 201 -400 Amp.
Service/Feeder 401-600 Amp.
Servie/Feeder 60'l-1 000 Amp.
Service/Feeder overl 000 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 201400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp. SeNice/Feeder 60'1 -1 000 Amp.
Portal to Portal Hourly
Signal CircuivLimited Energy - 1&2 DU.
Manufacturcd Home Connection
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 Garage
Each Swimming Pool / Hot Tub
Unit Charqe
$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
H $
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
^.-__Ttr
TOTAL
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 elect cal 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 c€rtify that I am the of the above named property or a licensed electrical contractor. I
am making the electrical insta,lation or alteration in comp liance h cal laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter296-
468, The City of Port Municipal , and Uti and PAMC '14.05.050 regarding Electrical Permit Applications.
t-
Date Print Name ignature Owner I Electrical Contractor / Administrator)
PROJECT DETAILS
[Electrical Pemit Applications may be su City Hall or epe its@cityofpa.us or faxed to 360.417 .47111
1.2 SF
.o}PEQt.,
Public Works and Utilities Department
321 E. 5th Street, Pod Angeles, WA 98362
360.417.4735 ; www.cityofpa.us electricalpermits@cityofua.us
OWNER INFORMATION
Name:
Name: