HomeMy WebLinkAbout1617 W 12th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-473s
RS7 RESDNTL SINGLE FAI{ILY
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REPORT STATE SALES TAX
on your excise tax form
to the City of Poti Angeles
(Location Code 0502)
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\Application Nun$er
Application pin nudber
Property Address
ASSESSOR PARCEL NUMBER :
Application t)'pe descriptsion
Subdivision Name
Property use
Property zoninq
Application valuation
19 000013 65 Dare 9/05/19
'7 2953 5
1617 Yt 12TH ST
06 -3 0 - 00- 0 - 3 -5946- 0000 -
EI,ECTRICAIJ ONIY
Application desc
carage conwersion
Contractor
EDWIN H MENES AND
1517 W 12th ST
PORT ANGEI,ES
136A) 115-54'17
IMEIDA M NER
wA 98353
JOTNSON ELECTRIC COMPANY
153 MCCARIIER F.D
PORT ANGEI]ES WA 983 62
.360) 72A-4327
Permi E
Additional desc
Permit' Fee
Issue Date
Expiration DaLe
73 .00
9/os/1-9
3/03/20
ELECTRICAL ALTER RESIDENTTA],
PIan Check Fee
Valuation
00
Qty Unit Charge Per
2.00 5.0000 ECH
1.00 53.0000 ECH
EL-ECH ADDI\IT BRANCII
'IRCI'ITEL-R- BRANCH CIR WOl SER FEED
Cha!ged Paid Creditsed Due
Permit Fee Total
Plan Check Total
Grand Total
73 .00
.00
?3 .00
73 .00
.00
?3 .00
00
00
00
00
00
00
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SER\'ICE
ROUGH.IN nlfl)."fi %Y
Zln/z-V &
PERMIT WILL EXPIRE SIx (6) MONTHS FROM [,A.ST TNSPECTION
Signature of owner or Electrical Contractor X Date
Ex!ension
10.00
53.00
0
#
FINAL w
COMMENTS:
ELr-2 sF
EL ECTRICAL PERM ITAPPLICATION
Public Works and Utilities Department
321 E.5th Street. Pon Angeles, WA98362
360.4\7.4735 lrvw.cityofpa.us I electricalpermits@cityofpa.us
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\l2\' 3Prolect Address:
Mailing Address w,L9
Project Description !I t
6 Single-FamityResidential n Duplex /ARU Building Square footage
Name:e wte 5 EmailL+5 Phone GO -7 1
O\^NER INFORMATION
ELECTRICAL CONTRACTOR I NFORMATION
Name
lvlailin
Email:
7cA
g Address
2a C L€C1k\ <License a*r.i Fa 17 RLis
$ iL "''
b9 t\. O<'-t< r Exp iration Date: y''^dv 2/.Zz
Phone ,L7
Ouantitv Igltal(Quantity x Unit Charge)Item
Service/Feeder 200 Arnp.
Service/Feeder 201 -400 Amp.
Service/Feeder 401600 Amp.
Service/Feeder 601-1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit WO Servic€ Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 40'l-600 Amp.
Temp. Service/Feeder 601-1000 Arnp.
Portalto Portal Hourly
Signal CircuiuLimjted Energy - 1&2 DU.
Manufactured Home Conneclion
Renewable Elec. Energy: sKVA System or less
Thermostat (Note: $5 for each additional)
Frrst 1300 Square Feet
Each Additional 500 square feet'.
Each Outbuilding / Detached Garage
Each Swimming Pool I Hot Tub
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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owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after 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 certiry that I am the owner of the above named property or a licensed electncal contractor. I
am making the electrical installation or alteration in compliance with the electrical laws, N. E.C., RCW Chapter .19.2g, WAC. Chapter 296-
TOTAL ) z-,!4-
464.City of Port Angeles Municipal Code, and Utility 14.05.050 regarding Electrical Permit Applications
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Print Name re(owner [[Electrical Contractor / Administrator)
PROJECT DETAILS
D
[Electrical Permit APplications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.411 .47 1l11
1 - 2 SINGLE-FAIVIILY
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APPROVED
ELECTBICAL INSPECTION
WIRING REPORT
417-4735
DITCH . ..9-tr
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BOUGHIN/COVER,..
SERVICE tr
tr....FINAL
?CORRECTIONS NEEDED: /tl!2-f ,. r r- ?Q,,'*?(p'.r\--i, -9-A
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NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED UTHIN 15 DAYS
_ DO NOT REMOVE_
DATEI -t1 INSPECTON
OWNEB
co
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IZ
ADORESS
NOT APPROVE
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