HomeMy WebLinkAbout1121 W 12th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -4735
RS? RESDNTL SINGLE FNYTLY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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o'
N
\ApplicaEion Nudber
Applicat.ion pin number
Property Address
ASSESSOR PARCEL NUI4BER I
Applicatsion t!'pe desclj.pLion
Subdlvision Name .
Property Use
Ploperty zoning
Applicationvaluat.ion .
2o-ooooo24s Datse 2/2!/2a
20't9lo
1121 W 12TH ST
05 30- 00-o-3 -5470-0000-
EI,ECTRICAL ONLY
ApplicaEi,on desc
Bath, KiEchen, Laundry remodeL / Service
ConEracEor
NAT}IAN L AND AMBER M EBY
1121 W 12TH ST
PORT A}.IGELES WA 983637033
OWNER
Permi!
AddiEional desc
Permit Eee
Issue Datse .
Expiratsion DaEe
1?0.00
2/2r/20
8/L9/20
ELECTRICAI ALTER RESIDE}.rrIAI
Pfan Check Pee
valuatlou
00
0
Qty unir Charge Per
1"0 .00 5.0000 Ecg1.00 120.0000 EcH
ExEension
50.00
120.00
EL- BRANCH CIRCUT" W/FEEDER
EL- O - 2OO SRV FEEDER
Fee summary charged Paid Cr:edited Due
PermiE Fee Totsal
Plan Check Total
Grand ?oEa1
1?0
170
00
00
00
170 .00
.00
170.00
.00
.00
.00
00
00
00
PERMTT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR
DITCH
SERVICE <lzo)zo d \ela
ROUGH-IN tltlqo dtr -8
FINAL /o )zx/zo J -w
COMMENTS
a
Signature ofowner or Electrical Contractor X Date:
a T
".#5Rr."T'EY
%;=6-c.
ELECTRICAL INSPECTION
WIRING REPORT
4174735
NOT APPBOVED
......D|TCH
. ROUGH IN/COVER . ...
.....SERVICE
......FINAL
APPROVED
tr ....
9,Q.6:2g,.-
tr
o
tr
tr
CORRECTIONS NEEDED:L.o,u H.DQV +cPI19+ r ,) rel-l-
'^'Zlt)ro oo-7,6---6tr-\INSPECTOR
|ll-1r<d)-tA4J d
O!!NER 'b<
CONTRACTOR
t)Z\ k)1,2-
ADDFESS
de-LqtaU C-rtvyD-
NOTIFY INSPECTOR WHEN CORBECTIONS
ARE COMPLETED WTHIN 15 DAYS
_ OO NOT REMOVE-
I
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ELECTRICAL PERMIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, 'rlA 98362
-160.417.47 35 | *nvw.cityofpa.us I electricalpennits@cityofpa.us
Prol ectAddress: 1121 W 12th St Port Angeles, WA 98363
Project Descrip Usn. 200 Amp Service and Panel Replacement. New Bath, Kitchen, and Laundry Area Circuits
tr Single-Family Residential E Duplex / ARU Building Square footage 1412
?Sc.-o
o
3to
!.rt-
Nc.q
f'l3ms; lathan Eby
[/ailing 466rs5s. '1 12'l W 12th St Port Angeles, WA 98363
Ema il: nathaneby@hotmail.com
p6ens.503-313-1217
Name Nathan Eby fi6s6sg; N/A - Owner
Expiration Date N/A - Owner
P hone 503-313-1217
N4 ailing Address 1121 W'12th St Port Angeles, WA 98363
Email. nathaneby@hotmail.com
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 Amp.
Service/Feeder 401600 Amp.
Service/Feeder 601 -1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Servlce/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp
Temp. Service/Feeder 401-600 Amp.
Temp. Service/Feeder 601-1O00 Amp.
Portal to Portal Hourly
Signal Circuiulimited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermoslat (Note: $5 for each additional)
Unit Charoe
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$5.00
s75.00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
Ouantltv Igta! (Quantity x Unit Charge)
1201$
$
$
$
$
$'10
$_
$
$
$_
$
$
50
$_
$_
$_
$
$
$;r
TOTAL
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 c€rtify that I am the owner of the above named property or a licensed electrical contractor. I
am making the electrical installataon 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 Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
211412020 Nathan Eby Nathan Eby Digitally signed by Nathan Eby
Oale: 2020.02.14 l6:44:10 -08'00'
Date Print Name Signature (@ Owner I Electrical Contractor / Administrator)
IElectrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa. us or faxed to 360.417.47111
1 - 2 SINGLE-FAMILY
OWNER INFORMATION
ELECTRICAL CONTRACTOR I NFORMATION
PROJECT DETAILS
Each Outbuilding / Detached Garage
$_
s 170