HomeMy WebLinkAbout128 E Front St (2)ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4r7 -473s
CENTRAIJ BUSINESS DISTRICT
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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$
-9
Applicalion Nun$er
Applicalion piD number
Property Address
ASSESSOR PARCEL M'MBER:
Application type description
Subdivision Name
Properiy Use
Property Zoning
Application valuaEion
18 - 0000134 9 Date A/29/la
133886
128 E FRONT ST
05-30-00- 5 - 1- r507 - 0000
EI,ECTRICAIT ONI'Y
AppLication desc
l{ood fan and outlets
Owner Conlractor
ED}TARD BoYD/MoNICA sTElcItEN
8OO OLYI'IPIC DR
FORKS WA 98331
SIMPSON EIECTRIC
243 035 W qWY 101
PORI ANGEIJES
13601 4s1-9270
wA 98363
Permit
Additional desc
Permit Fee
Is6ue Date .
Expiration Dat.e
E],ECTRICA], ALTER COMMERCIAT
14 CIRCUITS
86.00 Plan Check Fee
8/29/rs valuarion
2 /2s /L9
00
0
BASE FEE 85.00
Charged Paid Credited Due
Permit Fee Total
Plan Check Total
orand Total
86. 00
.00
86. 00
86.00
.00
85.00
00
00
00
00
00
00
PERMTT WILL E)(PIRT Slx (6) MONTHS FROM LAST INSPECTTON
INSPECTION T\?E DATE:RESULTS:INSPECTOR:
DITCH
SER\'ICE
ROUGH-IN ?'zr. t s #
FINAI )olE"lfr {a "Bt
COMMENTS:E
Date:
Qfy Unit Charge Per
I td)
Signature of ow:rer or Electrical Contractor X
MULTI-FAMI LY / COMMERCIAL
ELECTRICAL PERM IT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.411.4735 wwwcityofpa.us I electricalpermits@cityofpa.us
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\lsPoect Address '128 E Front St Port Angeles
Project Descripti on. 4- circuits Hood Fan Hook up and 2 Outlet* Spruce Restaurant
E Multi-Family Residential EI Commercial / lndustrial / Public Building Square footage
Name: Matt Brook Email
Mailing Address. 128 E Front St phone. 206-898-1070
ELECTRICAL CONTRACTOR INFORMATION
Simoson Electric LLC License: SIMPSELgT3RQ
Exp iration Date:'12111 120'tg
Phens 3604s7-9270
Mailing Address PO Box 1086 Port Anoeles. WA 98362
Email dlsimpsonSl @qmail.com
Item
Service/Feeder 200 Amp.
Service/Feeder 201 400 Amp.
Service/Feeder 401 600 Amp.
Service/Feeder 601-1 000 Amp.
Service/Feeder over 1000 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 201-400 Amp.
Temp. Service/Feeder 40'1600 Amp.
Temp. Service/Feeder 601-1 000 Amp.
Portal to Portal Hourly
Sign / Outline Lighting
Signal Circuiulimited Energy - Multi-Family
Signal CircuiuLimited Energy/Firsl 1500 sf - Commercial
(Note: $5.00 for each additional 1500 s0
Renewable Elec. Energy: sKVA System or less
Thermostat (Note: $5 for each additional)
Ouantitv IqEl (Quantity x Unit Charge)
86 0014
$
$
$
$
$
$
$
$
!
$
$
$
$
$
$
$
$
$
$
$'113.00
$56.00
86.00 rorAL
Owner as defined by RCW19.28.261: (1) Owner will occupy the structure for two years afrer this eleslrical permit is finalized. (2) Owner is
required to hi.e an electrical contractor if above said property is for saie, rent or lease. Permit expires after six months of last inspection.
After reading the above statement, I hereby cerfiry that I am the owner ofthe above named property or a licensed electric€t contractor I
am making the electrical installation or alteration in compliance with the electrical laws, N. E.C., RCW Chapter 19.28, WAC. Chapter 296-
468, The City of Port Angeles Municipal Code, and Utility Specilications and PAMC 14.05.050 regarding Etectrical Permit Apptications.
Andrew Simpson
Date Print Name Signature (D Owner F Electrica Contractor / Administrator)
lElectrical Permit Applications may be submifted to City Hall or electricalpermits@cityofpa. us or faxedlo 360.417 .47111
OWNER INFORMATION
Name:
PROJECT DETAILS
Unit Charoe
$132.00
$160.00
$225.00
$288.00
$410.00
$5.00
$74.00
$5.00
$86.00
$102.00
$12'1.00
$164.00
$185.00
$96.00
$88.00
$88.00
$96.00