HomeMy WebLinkAbout1203 Campbell Ave KELECTRICAL PERMTT
CITY OF PORTANGELES
360-417-4735
RE S IDENTIA], IiIGH DENSITY
0
REPORT STATE SALES I]AX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
-$\s
o
Application NNrber
AppLication pin nunber
Property Address
ASSESSOR PARCEL NUMBER:
Application ts,?e description
Subdivision Name
Property Use
Properly zoning
Applicalion valuaEion . .
L9-oooo1910 Dar-e a2 /o4 /L9
9017? 0
1203 CAMPBELIJ AlT K
06-30-14-5-3-0340-0000-
EI,ECTRICAL ONI,Y
Appfication desc
Nei, home
Contracto!
DON N]ITNS
PO BOX 212
SEQUIM wA 983 82
UPPER LEFT ELECTRIC LLC
1305 ROOK DR
PORT ANGELES WA 983 52
136O) 467-'t720
Permit
Additional desc
Permit Fee
lssue Date
Expiration Date
120.00
12/A4/t9
6/0L/20
ELECTRTCAT NEW RESIDENIIAI
Plan Check Fee
valuation
00
0
oly Unit Charge Per
1.00 120.0000 ECH EL-R-SQET EIRST 1300
Extension
120. 00
charged Paid Credited Due
vermlt !'ee l'oca l
Plan Check Total
120
12a
00
00
00
120. O0
.00
120.00
.00
.00
.00
00
00
00
PERMM WILLEXPIRE SIX (6) MONTHS FROM LAST TNSPECTION
INSPECTION TYPE DATE:RESULTS INSPECTOR:
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SERVICE v-lt4lfi dR 16r
ROUGH.IN ozinlff &-Et
FINAL zl'n lu P -F4>
COMMENTS:
DateSignature ofowner or Electdcal Contractor X_
ELECTRICAL INSPECTION
WIRING REPORT
417-47$
DATE INSPECTOfI
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ADDFESS
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APPROVED
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NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
_ DO NOT REMOVE_
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ELE CTRICAL PERM IT APPLICATION RA.
0ttPublic Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 I www.cityofpa.us electricalpermits@cityofpa.us
CC^vYr
n Single-Family Residential ! Duplex / ARU Building Square footage
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*_D
e,
Project Address
Project Description
O\\NER INFORMATION
Name
Mailing Address
;\./e-Email
Phone
ELECTRICAL CONTRACTOR INFORMATION
Name
Mailing Address
Email:
t License
Expiration Date:
Phone:
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401S00 Amp.
Service/Feeder 601 -1 000 Amp.
Service/Feeder over '1000 Amp.
Branch Circuit W/ SeNice Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Carcuat
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp
Temp. Service/Feeder 401$00 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Signal CircuiUlimited 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
s5.00
$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
Ouantitv lgltrl (Quantity x Unit Charge)
&-c./
$
$
$
$
5
$
$
$
$
$
)
$
$
$
$
$
$
$
$
$
$
$
$TOTAL
Owner as defined by RCW 19.28.261: (1) Owner will occupy the sfucture for two years ater this eleclrical permit is finalized. (2) Owner as
required to hire an eleclrical contraclor if above saad 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 oI the above named property or a licensed electrical contraclor. I
am making the electrical installation or alleration in compliance with the elect.ical laws, N.E.C., RCW. Chapter '19.28, WAC. Chapter 296-
468. The City oi PortAngeles [Iunicipal Code,and Util cations and PAMC 14.05.050 regarding Electncal Permit Applacations.
e
Print Name Owner ! Electrical Contractor i Administratoo
ILU
IElectrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa us or faxed to 360.417 .47111
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