HomeMy WebLinkAbout1216 Columbia St (2)ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -473s
RS7 RESDNTL SINGLE FAMIIY
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application Number
Appf ication pin nuntrer
Property Address
ASSESSOR PARCEL NUIVTBER :
ApplicaLion type description
subdivision Name
Property Use
Property zoning
Application valuation
19 -00001s96 DaEe to/1-'1/1-9
87 a964
1216 COI,UMBIA ST
05-30-00-5-3 - 062 0 - 0000-
EI,ECTRICAL ONLY
Application desc
DHP
Permit
Additional desc
Permit Fee
lssue Date
Expiration Date
53.00
ro / r't /te
4 /t4 /20
EIECTRICAL A],TER RESIDENTIAL
vlan cneck t'ee
ValuaEion
00
0
Qty Unit Charge Per
1.OO 53.OOOO ECH EL.R BRANCH CIR WO/ SER FEED
Extension
63 .00
Charged Paid Credited Due
Permit Fee Total
PIan Check Totsa1
Grand Total
53 .00
.00
53 .00
53.00
_ 00
53.00
00
00
00
.00
.00
.00
PERMIT WILL EXPTRE StX (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
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FINAL nlffi hs +f2 #
COMMENTS:
Signature ofowner or Electrical Contractor X Date
JA},IES E TAYLOR BI,ACK DIAMOND ELECTRICAI CONTR
1216 COLUMBIA ST 502 BI.ACK DIAMOND RD
PORT ANGE],ES WA 983624210 PORT ANGELES WA 98363
1t!31 11-11',1 1:::t tlt_iltl
ROUGH-IN
EL
Public Works and Utilities Department
321 E.5th Street, Pon Angeles, WA98362
360.417.4735 www.ciwofpa.us electricalpermits@cityofpa.us
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N\Project Address I l\t- Couuru161g
P Description Duc?Le$
S ingle-Family Residential E Duplex / ARU Building Square footage
L Email
73o-t17"-6lS-z
OVlAIER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
Name
Mailing Address
Email:
License
Expiration Date
Phone 3Lo -VCt-3s17
PROJECT DETAILS
Item
Service/Feeder 200 Amp
Service/Feeder 201400 Amp
Service/Feeder 40'1600 Amp
Service/Feeder 601 -1 000 Amp
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$00 Amp
Temp. Service/Feeder 601 -1 000 Amp.
Portal to Portal Houriy
Signal Circuiulimited Energy - 1&2 DU
Manufactured Home Connection
Renewable Elec. Energyr 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
am making the electrical
468, The City of Port An
installation or alteration in complia
lvlu n r Code, and Utility
Quantitv Total (Ouantitv x unit 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
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
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$trTOTAL
Owner as defined by RCW 19.28.261: ( 1) Owner will occupy the struclure for two years afrer this eleclrical 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 statemenl, I hereby certify that I am the own above named property or a licensed electrical cont.actor. I
with e llaws, N.E.C., RCW. Chapter 19.28 WAC. Chapter296-
nd PAMC '14.05.050 regarding Electrical Permit Applications.
Date
lo- t
Print Name Owner ! Electrical Contractor / Administratoo
[Electrical Permit Applications may be subm ity Hall or epermits@cityofpa. us or faxed to 360.417.47111
L1-2 sF
1 - 2 SINGLE-FAMILY
Name:
Mailing Address: lL l b Z o L v,,,lf tA Phone'