HomeMy WebLinkAbout1308 Georgiana StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RS7 RESDNTIJ SINGLE FA]VIILY
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Pod Angeles
(Location Code 0502)
--D
\\\$
\Application Nunlcer
AppllcaEion pin number
Property Address
ASSESSOR PARCEL NT]MBER:
Application tl'pe description
Subdivision Name
Pr:operty Use
Property Zoning
Applicatsion valuatsion
19- 00000695 Datse 5 /t4 /19
209230
13OA GEORGIANA 51]
06 - 30- 00 -5 - 3 - 143 7- 0000 -
ELECTRICAIJ ONIJY
Application desc
Service manufactured home
MoRRTSoN DANIEL L /
PO BOX 3051
PORT ANGELES
KETIE T
wA 983 62 0338
EXTRA MILE TECH & ELECT., ],LC
418 N. RACE ST.
PORT ANGELES WA 983 52
13601 4s7 -s222
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
120 .00
s /14/a9t!/la /t9
ELECTRICAL ALTER RESTDEI{ITAI]
00
ory
1 .00
Units Charge Per
12O.OOOO ECH EL MANI I{OME SERVICE & EEEDER
Extension
120.00
Fee summary Paid Credited Due
Permit Fee Total
PIan Check Total
Grand Tota1
120
120
00
00
00
00
00
00
l2a
124
o0
00
00
00
o0
00
PERMIT WILL H(PTRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH dpr-
SERVICE -xle) n W lLldr>
ROUGH.IN ,
FINAL t)al fi d?w
Signature ofowner or Electrical Contractor X Date:
Charged
Pla,l Check Fee ,
Valuatiolr 0
l,'lsln w
COMMENTS:
1-2StN GLE.FAMILY
ELECTRICAL PERM IT APPLICATION
Public Works and Utilities Dcparhncnt
321 E.5th Street, Port Angeles, WA98362
360.417.4735 | www.cityofpa-us I electricalpermits@cityofpa.us
5+.r*4t
EECBLEI)
|IAY t j 2n1g
8I!tlrlrlrs-lislq
ProJ:ect Address:3o8
Name:
Mailing
ti|.i
Address.r')
<\ r\)
2ootlr
Duplex /ARU Building Square footage:
Name:LE Te
Mailir€ Addre3s:o. B-x 3rr-g
Email:ol
lbm
SerYidFceder 200Amp-
Service/tueder 201400 Anp-
SeruigHer /()1600Arqp
Sewice/Her 601-lqD Arnp.
Se.dcrrFeeder o,3r 1 0(D Aftp.
Branctr Cilrjit l,t? S€wicc Fccder
Brandr Cirorit t flO ServiE Feeder
Eacfi Additional Brandr Cirorit
Bra.tch Cieils 14
Temp. Servic€rFeeder 20O Amp.
Temp. Serliae/Feeder 2Ol -40O Amp.
Temp. Se ixrFeetu il()'l€oo Arnp.
Temp. Seryic€rFeeder G01-1000 Anp
Porbl to Portal tiouly
Signal CirEiuEnitsd Ene.gy - 182 Ot .
MerufuEfrrrEd HoIIE Corlnedior
Reneryabb EhG. ErErgy: slryA Sy8lan a le3s
Themo€tat (Note. $5 br eadr addtional)
Fil8t t3O SSrrIe Feet
. Ea.ir A.rdn ond 50O cquep ftat"
. Eadr ollbtddtrrg I D€nadrd GT€e
Edr $rirmhg Fool I Hot lub
Ex
Email:F)
Phone:ft-
License:€xfP4tlr?73RL
l"L Expiration DaE:/2-2b^2ot1
Phone:1Go -461 - r3ts8
Itr@,
TOTAL
IgEl (Qnntity r Untt ctrrg€,
I2d..',-
unit Charqe
3120.m
31/t{t.m
$205.m
e62.m
t373m
$5.00
sa 00
$s.00
frs 00
$93 00
sl10.00
sr49.m
9168.00
t96.00
$64-g)
s120.m
9102"ql
s56.00
s120.0
tro.00
5r4.m
tl10.@
$
$
$
$
$
$
s
t
$
$
$
s
!
$
$
s
s
i
I
$
s y'z?,'"
O\rflet as ddned by RCVU 1 9.2E.261 : (1 ) Owner wf,l ccspy lhe structure for two ycara aiar thi6 ehdical permit iE finalized (2) Of,ner is
,€quired io hire an electical Gont'ador if above said poperty B ,or sab, reit or lesse. Permt expieg after six months of last hspaction.
Aie. reading the above 6€bment, I hereby c€.t'ry that I am lhe owner of tllg above named propefiy or a lbenEed electical corbador. I
am making the elec0ical hstallation or starstion in comp[anca with th€ el€61,ical lars, N-E,C., RCW. Ch4ier 19.28, WAC. Ctapter 29&
468, The City oi Po{l Aigele-B Mudeipal Code, snd Specifications and PAIT C 14.05.050 ing Ele€:trlcal PermitApplications.
t7 .%.
Date Print Name Signature (E Oxner Elec'fical Contractor / Administrator)
(+a d.J.j
lEleclrical PermitApplications may be submitted to City Hall or electricalpermits@cityofra us or fared lo 360-417.47111
IEiiE