HomeMy WebLinkAbout1203 Campbell Ave GELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4t7 -4735
)a*EP@RtroSfA T E S ALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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ApplicaLion Nurnlcer
Appl.icatsion pi.n number
Properly Addres6
ASSESSOR PARCEI, NUMSER:
ApplicaLiofl t,?e descriptio!
Subdivision Name .
Propertsy use
Propertsy zoning
Applicatsion valuation -
20-00001075
94337s
1203 CAMPBEI,I, AIIE G
05 -30 - 14 -5 -3 -0340 -0000 -
ELECTRICAIJ ONLY
RESIDENTIAI H]GII DENSIIY
0
Application desc
Neu ilome
Contractor
DON NIVB.IS
PO BOX 212
sEQUr14
UPPER ITERT ELECIRIC LLC
1305 ROOK DR
PORT ANGEIES WA 98362
1360) 461- 7',720
wA 98382
Permit
Additional desc
Permit Fee .
Issue Date
Expiralion Date
120.00
ro/08/20
4/ 06 /2L
Plan check Eee
valualion
ELECTRI CAL NEW RESIDENTI]\]T
00
0
Oly Unit Charge Per
1.00 120.0000 Ecil Et-R-soFT FIRST 1300
Extension
120. 00
Charged Credi!ed Due
120.00
.00
120.00
120.00
.00
a2o. oo
.00
.00
.00
.00
.00
.00
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE jl-L7-2D t4r4 /4&
ROUGH-IN ,l- *3- 30 ,8
FINAL zlt /zt 18 AE
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM I.A.ST INSPECTION
Signature of owner or Electrical Contractor X Date
Permit Fee ToEal
Plan Check Total
Grand Totsal
A<oD
!oil ELECTRICAL INSPECTION
WIRING REPORT
4't7-4735
APPROVED
coBREcroNS NEEDeo, /1DY- €u+rE- t'o a- Vt+\2
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OATE zo-)6af-wINSPECTOR
OWNER
CONTAACTOB
)?ab Cot-$Y*l-1.-.- Gt
TAP
NOTIFY II{SPECTOR WHEN CORREGTIONS
ARE COMPLETED WTHIN 15 DAYS
_ DO NOT REMOVE -
tffipn-
ELECTRICAL PERM IT APPLICATI ON
Public Works and Utilities Deparrment
321 E. 5th Street, Port Angeles. \[A 98-162
-160.4 I 7.47-1-s I vi.irrt.citvofpa.us I elccrricalpcnnits(lcityofpa.us
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Proje ct Address: 1203 Campbell ave Unit G
550 sq ft one bedroom unit
550
lvlailing Address Phone
Name. upper left electric License
Mailing Address:
E6311. upperlefte lectri mail.com
Exparation Date
Phone:
Item
Service/Feeder 200 Amp.
Service/Feeder 20'l-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 401-600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Signal Circuivlimited Energy - '1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy sKVA System or less
Thermostat (Note $5 for each additional)
Firsl 1
Unit Charoe
$120.00
$146 00
$205 00
$262.00
$373.00
$s.00
$63 00
$s.00
$75.00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$s6.00
$120.00
Ouantity Ighl (Quantity x Unit Charge)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Date Print Name Signature (E Owner ! Electrical Contractor /Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed lo 360.4j1.4111)
1 - 2 SINGLE-FAIMILY
Project Descriplion:
n Single-Family Residential E Duplex / ARU Building Square footage:
O1AAIER INFORMATION
Name. Don Nivens Email.
ELECTRICAL CONTRACTOR INFORMATION
PROJECT DETAILS
Each Outbuilding / Detaiied carage
1
1
$s_rorAL s 120
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 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 Port Angeles Municipal Code, and Utility Speciflcations and PAMC 14.05.050 regarding Etectrical permit Apptications.
81312020 chace botero