HomeMy WebLinkAbout123 W Park AveApplicaiion Nuiber .
application pin nunber
Property Address
ASSESSOR PARCEI, NUMBER:
ApplicaEion type descr:iPlion
Subdiwision Name
ProperEy use
Proper.Ey zonj.ng
Application valuation
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
19 - ooo0112o Daie 7/26/19
984 00 0
123 W PARI( AVE
06- 3 0 - 09- s - 2 - 3 662- 0000 -
ELECTRICAL ONI,Y
RS7 RESDNTT STNGIE EAIVIILY
o
REPORT STATE SATES IAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Applicatsion desc
Ductless heat PumP
Contsractor
Permit
Additional desc
Permit Fee
Issue Date
Expiratsion Datse
53 .00
'1/26/t9
1-/22 / 2a
Qty U[it Charge
1.00 53.0000
Per
ECH
ELECTRICA], ALTER RXS ]DENTIAI,
EL-R. BRANCT{ CIR WO/ SER EEED
.00
o
ExEension
53 .00
Permit Fee Totsal
Plan Check Total
Grand Total
63 .00
.00
63.00
63 .00
.00
53 .00
.00
.00
.00
00
00
00
PERMTI WILL EX?IRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTOR:INSPECTION TYPE DATE:RESULTS:
DITCH
SERVICE
ROUGH-IN z )u- /e w B\
FINAI "Lt lt?4.F'wql
COMMENTS:
I
TII
TI
Signa ture ofowner or Electdcal Contractor X Date
TIM I]EUSSEY AND CIJAUDIA M COOK BI.ACK DTAMOND EI'ECTRICAL CONIR
123 W PARK AVE 502 B'.ACK DIAMOND RD
PORT ANGEIES WA 9A3626960 PORT IUIGELES WA 98353
(350) 41? 2511 (360) s5s-1035
Plan Check Fee
Valuatior!
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ELECTRICAL PERM IT APPLICATION
Public Works and Utilities Department
321 E. sth Street, Port Angeles, WA 98362
36A.417.4735 www.cityofpa.us electricalpermits@cityofpa.us
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3
RECEIVED
JUt ? 5 2019
Project rESS tz7 ?0zr 416
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P escription Du s rl-f
Single-Family Residential ! Duplex /ARU Building Square footage
CooLSo^)EmailName
Email
Mailing Address
Name
l\ilailing Address
l?.3
"ALtLAve-
Phone l7-tl
License
Expirati
Phone:
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Servicei Feeder 201-400 Amp.
Service/Feeder 401S00 Amp.
Service/Feeder 601 -1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuil W Service Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Houdy
Signal CircuiVLimited Energy - 1&2 DU.
Manufactured 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
lJnit Charoe
$120.00
$146.00
$205.00
$262.00
$373.00
$s.00
$63.00
$5.00
$75.00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$s6.00
$120.00
$40.00
$74.00
$110.00
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Ouantitv IqE!(Quantity x Unit Charge)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
17 t
TOTAL
Owner as defined by RCW 19.28.261: (1) Owner will occupy the structure for h,vo years afier 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 certify that I am the own rof above named property or a licensed electrical contractor I
am making the electrical installation or alteration in compliance llaws, N.E.C., RCW Chapter'19.28 WAC. Chapter296-
468, The City of Port Angeles t\.4u , and Utility and PAMC 14.05.050 regarding Electrical Permit Applications
Date Print Name nature (! Owner ! Electrical Contractor / Administrator)
[Electrical Permit Applications may be submitte Hall or epermits@cityofpa.us or faxed to 360.4'17.47111
1-2 S
1 - 2 SINGLE-FAMILY
O\iryNER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION