HomeMy WebLinkAbout1203 Campbell Ave JELECTRICAL PERMIT
CITY OF PORTANGELES
360-417-4735
R.ESIDENTIAL HIGH DENSITY
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REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application Nufliber .
Application pin number
Property Address
ASSESSOR PARCEL NUMBER I
Application t).pe descriptsion
Subdivision Name .....
Property Use
Property zoning
Application valuacion .
19 - 00001911 Dal-.e 12/04/19
9',7 504'7
1203 C.AI4PBELL AVE J
06-30-t 4-5-3-0340-0000-
ELECTRICAL ONI.Y
ApplicaEion desc
New home
ConEractor
DON NII,ENS
PO BOX 212
SEOUIM vtA 98382
UPPER LEPT ELECTRIC I,LC
13 06 ROOK DR
POR? ANGELES WA 98352
1360) 46]--7120
Pernit .
Additional desc
Permlt l'ee
Issue DaEe
Bxpiratsion Date
120 _ 00
t2 / a4 /a9
6 / Ot/20
ELECTRICA], NEW RISIDENTIAI!
Plan check Fee
valuatl0n
00
0
Qty Unit Charge Per
1.00 120.0000 EcH EL-R-SoFT FrRsT 1300
Extension
120.00
Fee summary charged Pai.d Credited Llue
Permit Fee Total
Plan Check Total
Grand ?oEa1
1-20
120
00
00
00
120.00
.00
120. 00
o0
00
00
.00
.00
.00
PERMM WILL EXPIRE SIX (6) MONTHS FROM I"A.ST TNSPECTION
iNSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE r2-h1lt1 EF -EF
ROUGH.IN r-lfile s-v w
FINAL zinlzt -eAV %rI)
COMMENTS:
Signature ofowner or Electrical Contractor X Date
9oar ELECTRICAL INSPECTION
WIRING REPORT
417-4735
OATE INSP€CIOA
'2-D "R?
CONTRACTOR\>47€-YL_ L-hTa-
ADDRESS
12-D e-Jt-
APPROVED
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)CORRECTIONS NEEDED:
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NOTIFY INSPECTOB WHEN CORRECTIONS
ABE COMPLETEO WITHIN 15 DAYS
- DO NOT REMOVE _
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9-
E LECTRICAL PERM IT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
364.417.4735 www.cityofpa.us electricalpermits@cityofpa.us
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Project Address:
Prolect Description 5Cq 1..+ L-c-"r Vy)^.^-
OWNER INFORMATION
Mailing Address
Email:
Email
License
ELECTRICAL CONTRACTOR INFORMATION
Expiration Date
Phonei
PROJECT DETATLS
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 WO Servic€ Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201400 Amp.
Temp. Service/Feeder 40'1.600 Amp.
Temp. Service/Feeder 601 -1 000 Amp.
Portal to Poftal Hourly
Signal Circuivlimited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
First '1300 Square Feet
Each Additional 500 square feet"
Each Outbuilding / Detached Garage
Each Swimming Pool / 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
Quantity Total(Ouantitv x Unit Chardel
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
\79
TOTAL I ?,-r)
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 complianc€ wjth 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 PAN,C 14.05.050 regarding Electrical Permit Applications.
Date Print Name r ! Electrical Contractor / Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxedlo 360.4'17.471'l)
L1-2 s
1 .2 SINGLE-FAMILY
E Single-Family Residential n Duplex / ARU Building Square footage: _
Name:
Nlailing Address: Phone:
Name: