HomeMy WebLinkAbout120 Forest AveELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4t7 -4735
RS? RESDr.rII SINGLE FAMII,Y
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application Nufiiber '.
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application tl,?e description
subdlvision Name .
Property use
Property zoning
Application valuation
20 - ooooo3 31 Date 3/1a/2o
002196
120 FORXST AVE
06-30 - 0 9- 5 - 2 -3520 - 0000 -
E],ECTRICAt ONIY
Applicatsion desc
Kitchen recess / cas fireplace
OqIIter ConEractor
Lloyd & Lisa Divelbliss
120 !l Forest Avenue
PORT ANGELES WA 983 52
1360) 610 -144s
BOB'S ELECTRIC INC
2293 DEER PAR( I'D.
PORT ANGEIES
(360) 457-5887
wA 983 62
Permit
Additional
Permits Fee
fssue Datse
ELECTRTCA], A],TER RESIDEI{TTAI,
1-4 CIRCUITS
?5.00 Pla check Fee
3/to/2o vafuat ion
e/06/2a
desc
o0
0
E){)iratsion Date
Qty Unit Charge Per
BASE FEE
Extension
75 .00
Charged Paid credited Due
Permit Fee Total
Plan check Totsaf
Grand 'fotal
75 .00
.00
75_00
75.00
. o0
75_00
00
00
00
00
00
o0
INSPECTION T\?E DATE:RESULTS INSPECTOR
DITCH
SERVICE
ROUGH-IN zlv.lao x -$q>
FINAL
COMMENTS:at, 4lts14
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTTON
Signature ofowner or Eleatrical Contractor X Date
V.
APPROVED
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&aarei€Nii TiFEDED
SERVICE.....
FINAL
ELECTRICAL INSPECTION
WIRING REPORT.
4174735
NOT APPROVED
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CONIFACTOF
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NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED wlTHIN 15 DAYS
_ DO NOT REMOVE -
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1 .2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION
Puhlic Wbrks and 1.:tilitiss l)cpartmcnt
321 Ii.5th Slrect. Porl Angcles, \\l{ 98162
160..t|7.'l7i: xn *.c iLytrlpa.us elcctricalpcrrrr itr, a)c ity o lpa.ir s
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ProjectAddress;
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ingle-FamilyResidential E Duplex / ARu Building Square footage:
Name ,iJ'
)"/<s r(u
?f-sd )
ry' f.,
^'t&
Mailing Address
Name;
Mailing
Email
Email
Phon€
License
Phone
ration Date:
Unlt Charoc
$1m.00
s146.00
$205,00
$262.00
$373.00
55.00
$63 00
s5.00
$75 00
$93 00
s110.00
s149.00
9158.00
$96.00
s64.00
s120.00
$102.00
s56.00
s120.00
940.00
gr4.m
st10.00
Itbl {Aurtoly r Unn Chargs)
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Owner as defined by RCW 19.28.261i (1) O^rne. will occuly lhe sEucrure for two years after this eleclricrl f,ermit as finalized. (2) Owner is
required to hire an ebcldcal @ntractor if above eaid property is forsate. rent or l.ss€. permit expire6 after sU months of tast inspeclion.
Atter reading &e above stat6ment, I h€r€by certit that I am the owner ofthe above nam.d property or . licensed electrical contraclor. I
am making the elec,trical installatbn or alteration in compliance with the eleclncal laws, N.E C.. RCW Chapter 1s.28 WAC. Chapter 296-
46 City ol Port Municipal Code, and l..rtil ty 14 05.050 regarding Ehctrxral Permit Applicaljons.
nt re(E OwnerE Electrical Contractor / Adminiskator)
Anseles
Gt,
lElect.ical Permit Applications may be submited to City Hall or electricalpermits@cityofpa us or laxed to 360.417.4711)
Project Description
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S€rvk Fe€der 200 Amp.
S€rvics/Fe€der 20t4m Afi p.
Servbe/Feeder 401 6m &rp
Service/Fe€der 601- l m0 Anp.
&rvice/Feeder over 1000 Amp.
Brandr Circuit w/ Sorvice Feeder
Branch Circuit w/O Service Feeder
Eaoh Additronal Branch CiGlit
Branch Cicrits 1-4
Temp. SeryicrFeeder 200 Amp.
Temp Servicer'Feeder 201-400 Amp_
Temp. ServiceJFeeder 401 600 Amp.
Temp. Servic€r'Feeder 601-1000 Arnp
Portalto Portal Houdy
Sqnal Cirdit/Limit d Energy - 1&2 OU.
Manur8cbJrBd Hom€ ConrEctirn
Renewable Ebc. Eneey: 5KVA Sysbm or less
Thnno€tat (Nole: $5 fo. each ddilional)
Fi.J t30O Square F6€t
Esch Additronal 500 lquaG Ed"
Each Ot tbuiHing / Dete€iod GsrEgB
E.dr Sviftming Pool / Hot lub
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