HomeMy WebLinkAbout2103 W 12th St (2)ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -4735
RS9 RESDNTL SINGLE EA[!II,Y
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Application Number
Application pin number
ProperEy Address
ASSESSOR PARCEI NTUIV1BER :
ApplicaEion type description
Subdivision Name
ProperEy Use
Propertsy zoning
Application vafualion
22 - 00000412 Date 4/1-2/22
4 313 04
2103 W 12TIt ST
06 -30 - 01-5-0 - 02 80-0000 -
ELECTRICA! ONIY
ApplicaEion desc
Heat pump system
.,ANET ISETT
PO BOX 2553
PORT ANGELES wA 98362
A],L WEATI{ER HTg & COOLING lNC
302 (EMP ST
PORT ANGEI,ES WA 98352
(350 ) 4s2-9813
Permib
AddiEional desc
PermiE Eee
Issue DaCe -
55.00
4/L2/22
r0 / a9 /22
Plan Check Fee
Valuation
EIECTRICAI ALTER RESIDENTIAL
00
0
Expirat'ion Date
Qty UniE charge Per
1. OO 56 , OOOO ECE EL-L\II-TIIER.I{OSTAT
ExEension
56-00
charged Paid CrediEed Due
PermiE Eee Total
Plan Check Total
Grand aoLa]
56.00
.00
56.00
55.00
.00
56.00
.00
.00
.00
00
00
00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION T\?E DATE:RESLILTS:
DITCH
SERVICE
ROUGH-IN z)re,le-YS w
FINAL 't l*loz-AV
COMMENTS:.\
PERMIT WILL EXPIRE Srx (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date
G EXCHANCF BTJILDINC
INSPECTOR:
-&
ELECTRI CAL PERMIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Po$.Angeles, WA 98362
360.417.17 35 | www.cityotpa.us I elecrricaipermits@cityofpa.us
2103 West '1 2th Street
1lo
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Project Address
Project Descript 1on. lnstall heat pump system
tr Single-Family Residential ! Duplex / ARU Building Square footage 1287
Name Jan lsset Email
[,4ailing 466r".. PO Box 2663 Phone . 360-460-8181
Name. AllWeather Heating & Cooling, lnc Licerise:ALLWEWH934MU
Mailing Address 302 Kemp Street Expi ration Date: 9/22
Email billin allwe
Service/Feeder 201-400 Amp.
Service/Feeder 401-600 Amp.
Service/Feeder 601- l000 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. Servlce/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401 -600Amp.
Temp. Service/Feeder 601-10Q0 Amp.
Portal to Portal Hourly
Srgnal CircuivL,m;ted Energy - 1&2 DU
Manufactured Home Connection..
Renewable Elec. Energyi 5KVA Srstem o
Thermostat (Note: $5 for each additional)
Phone.360-452-9813
Unit Charqe
$120.00
$146.00
$205.00
Charge)
$373.00
$5.00
$63 00
$s 00
$75 00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
$
$
$
$
56.00
Owner as defined by RCW 19.28.261i (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 certify that I am the owner of the above named property or a licensed electrical 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 PortAngeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Appljcations.
411112 Karen McKeown Karen [VcKeown 3:{:,|'J,'3?1,?'o[1;}y1',",3X"
Date Print Name Signature (E Owner p Electrical Contractor / Administrator)
IElectrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa. us or faxed lo 360.417.47'l1l
$56.00
1 - 2 SINGLE-FAMILY
:P''8O,JECT DETAILS
Item
$,
$_
q
$ ,..
$.___--
'$_
.$_
q
$120.00
$40.00
$74.00
TOTAL
Please and return to Public Works & Utilities ent
MAIL OR DELIVER COMPLETED FORM TO: 321 E sTH STREET; PORT ANGELES, WA 98362
F AX rO: 360417 -4711
Electrical lnformation Form
Public Works & Utilitles Departmsnt (360) 417-4700
City Electrical lnspector (360) 4174735
fi
!r
i
Cell Phone:
Project Address:
Owner:
Sfreet Address
cw/state/zip:
Phone Number:
Company Name:
Contact Name:
Phone Numher:Cell Phone:
L--.1 txrstrng
E Single-family residence
E Commercial
E Overhead service
E Underground service
ENew
E Mufti-family residence; # of units
E subdivision
E General service
E other:
Deta il ed des crlpti o n of
wo*: (Oil to Gas
Conversion, Gas to
Electric, New Heat Pump,
etc,)
Main Disconnect Size Select Voltage: ZIZO1ZIO qn Et zolzoe :pn
E+ao sw spn
&tt ruao epn
Amps:Ztzotz+o lpn
L] Standard residential loads (Lighting, refrigerator, dishwasher, washer)
n Rtc 1
-
tonl E Range/oven E Hot tuo
E Clothes Dryer E Heating E Pumps ( Hp)
E Water Heater E Elevator ( Hp) EOther_
Check all that apply:
Load lncrease (Load Decrease (kW)--
-Detailed plol plan (.dwg or .dxf format mandatory for subdivisions).
.Electrical one-line drawing showing the service entrance panel and localion
-Connected load data.
.Size and locked rotor amps of all motors over 50hp.
Please provide a copy of the following:
Applicant's Signature:Date
Applicant lnformation
Contact lnformation
Project Type
Project Information
NswdofosrdiormForm per Trent Revised 1-09-11
WS
Supporting