HomeMy WebLinkAbout4400 C St Wps (2)Application Numlcer
Application pin nudber
Proper.tsy Address
ASSESSOR PARCEL NUMBER:
Application t!?e descriptsion
Subdivision Name
Property Use
Propercy Zoning
Application valuation
19- 0000121s Dare 8/1-4/L9
550350
4400 c sT wPs
R5-3 0- 00 - 0- 0 - 0000 - 0000-
ELECTRICAI ONLY
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
PUBLIC BUIIIDINGS & PARKS
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Application desc
GENERATOR LOA.D BANK
Owner Contsractor
C]TY OF PORT ANGELES
PO BOX 1150
PORT ANGELES
LEGACY TELECOMMUNICATIONS INC
PO BOX 350
BURIEY WA 9A'\22
l2s3) 858 0214
wA 983620217
Per.mit
AddiEional desc
Permit Eee
Issue Datse
Expiration Date
EI,ECIRICAL AJ,TER COMMERCI]\I
GENERATOR LOAD BANK
164.00 Plan Check Fee
A/t4/19 valuaEion
2/ta/20
00
0
oty Units Charqe Per
1.00 164-0000 EClt EL- coMM 401-500 ?EMp SRV/FDR 154. 00
Char:ged Paid Credited Ihre
PermiE Fee Totaf
PIan Check Total
Grand Total
764
'1 54
00
00
o0
00
00
00
PERMIT wlLL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION Tl?E DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN 6fnhq rR @
FINAL s/rzlt1 N H[
Signature of owner or Eleckical Contractor X Date:
164. O0
. o0
154 .00
- 00
.00
.00
COMMENTS:
[/IULTI.FAIU ILY / COMIU ERCIAL
ELECTRIC PE ITAPP LICAT roN
Public Works and Utilities Departtent
321 E. sth Sheet, Port Angeles, WA 98362
360.417.4735 | www.cityoba.us I electricalpermits@,cityofoa.us
4+w C5{'
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t
J.}
t!
BEc€ryr",
Auo t2 2i;
Fairmount P/S South C St Port wA 98362Proj6ct Address:
Load bank 1 q enerator for Annual f\ilaintenanceProject Descriptiorl:
n lvlulti-i:aitrily Residential E Commorclal / lndustrial / Public Bullding Square footage:
Ciiv of Pod Anoeles
Mailing Address:PO Box 1150 Port Angol es, WA 98362-0217
Email:
Phone:360-565.3860
Name Le.JacV Tslecomfiunications Llcanse:LEGACTLS2l LL
Explration Date:
Phone:253-858-0214
T-olel (Quantlty x Charge)
$_
$_
$_$--
$_
$_
$_
$_
$-0_
9-
r 164.00
$--s---$--$--
$-
Mailing Address PO Box 360 Bu 98322
Email : rhenry@l eqacypower.com
E_--,',
ttem
Service/Feeder 200 AmP.
Serulc€/Feeder 201-400 AmP.
Servlco/Feod6r 401 -600 AmP.
Sorvico/Feeder 60 l-'1000 An"'p.
Sgrv{ce/Feeder over 100o AmP.
Branch Clrcuit \trl Servic€ Feeder
Branch Circlrit W,lO Seryice Feeder
Each Additional Br"nch Circuit
Branch Ciiouils 1-4
Temp. ServiceFeeder 200 AmP.
Temp. Service/Feeder 201100 AmP.
Temp. Servico/Feedor 401-600 Amp.
TEmp. Serl/ice/Feedsr 601-1000 Amp,
Portal to Portal Hourly
SIgn / Outlinc Lighting
Slgnal Circuit/Limited Enorgy - Multi'Family
Slqnal Circ'riulimiled EnersyiFirst .l500 st - Commsrclal- {Note: $5,00 for 6ach sdditionsl 1500 sf}
Ren€'/',/ablo Elec. Energy: SKVA System or le8s
Thormostat (Noto: $5 for sact additlorlsl)
Ouantitv
$132.00
$160,00
$225.00
$288.00
$410.00
$5.00
$74.00
$5,00
$86.00
$102.00
$121.00
$1q4.oo
$185.00
$96.00
$88.00
$88.00
$96.00
$113.00
$56.00
$_s_
t 164.00 TOTAL
Own6r as defined oy RcW. i s.28.z61: (1) Owner wlll occupy tho structure fortwo years afie. this eleclrical pormit is finalized. (2) Own€r b
*qri*J t" t ir"
"^ "r"c*ical
conlractor il above said prop€rty ls for sale, fsnt ol leas6, Psrmlt explrgs 8ft6. six monhs of last insp€ction'
After reading the above statement, I h€roby cedry that I arn th€ owner oflhe above nornod prop€rly or a llcensod elsctrical contractor' I
am making the electrical installation or altBration ln complance rrvi6 the electlical lar/3, N.E.C,, RCW. Chapter 19 28, WAC. Chaptor 296-
468, Th6 City ofPortAhgeles Munlcipal Code, and Utlllty Spocilicati,cns 14.05.050 rogarding El6ctrical PermitApdicetion6
8/8/1e Rich Hen
Date Print Name 1! Owner I Electrical Contractor /Administrator)
lElectrical Permit Applications may ba submitted to City Hall or epermits@cityofpa'us or (axed to 360.417.47111
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OWNER INFCRfuIATIOI\
Namo:
CONTRACTOR INFORI\4ATION
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