HomeMy WebLinkAbout1203 S Laurel StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4t7 -4735
RS7 RESDNTL SINGLE FAMILY
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Applicatlon Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Appf icat.ion tsype descriplion
Subdivi6ion Name .
Property Use
Properly Zoning
Application valuation
19-0000r.12a Datse 7 /26 /L9
551800
1203 S I,AI]REL ST
06 - 30 - 00- 0 - 3 - 8040 - 0000 -
ELECTRICA], ONIY
Applicatioa desc
4 eircuita???
Owner Contractor
DANA LEIGH WOOLDRTDGE
1203 S LAUREL ST
PORT ANGELES }IA 983627735
SHAMP EIECTRICAI CON?RAC"TING
PO BOX 381
PORT ANGELES WA 98352
(350 ) 452 1689
Pernit.
AddiEional desc
Permits Fee
Issue Date
Expiration Date
ELECTRICAL AI,TER RESIDENTIAI
1-4 CIRCUITS
?5.00 Plan Check Fee
1/26/L9 valuation
t/22 /20
Oty Uni! Charge Per
.00
0
Extsenslon
75. O0
Fee summary Charged Paid credited Due
Permit Fee ?otal
Plan Check Totsal
Grand Total
75.00
.00
75.00
?5. 00
.00
75. OO
00
00
00
00
oo
00
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
COMMENTS 44 )'22-
PERMTT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signa ture ofowner or Electrical Contractor X Date:
ELEC TRICAL PER MITAPPLIC roN
Public Works and Ulilities Departtnent
lll E. 5th Street, Por1 Angeles. 1&A 9E362
360.41'1.4735 | www.cityofpa.us I elcclricalpermits(@cityofpa.us
le-Family Residenlial E Dupler / ARU Building Squarc footage
Email:
Phona:
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Projecl Address:
Project
Namel
Mailing Address t
Name
Mailin
Email:
Licens€;
Expiration Date
Phone
Ch.rgc)llrltr
Service/Fccder ?OOArF. 5120-00
Servica/Feeder 201-1OO Amp. $146.00
Se.vice/Feeder 401€00 funp. $205.00
SeMce,/Feeder 6o'l-loooAmp. 3262.m
Service/Feeder over 10OO Amp. 9373.00
Brandl Circrrit W Seryice Feeder $5.00
&andr Circuit W/O Servic€ Feeder $63.00
Each Addrtional BrEndr Circuit $5.00
Brardr Circuits 1-4 S75.@
Temp. SeNice/Feed8r 2ooAmp. 193.00
Temp. Servic€/Feeder 2Ot-400 Amp. $110.00
Temp. Service/Feeder 401600 Amp. $149.00
Temp. SeNic€/Feeder 60'l -'l Ooo Amp. t168 00
Portalto Portal Hourly 596.00
Signal Cinuiulimited Eneryy - 1&2 DU. $64.00
Marufacrured Home Connection $120.00
Rensdable Ebc. Energy: sKVA System or less S102.m
Thermostat (Note: $5 for each additional) $56.00. -1i:iil . Ftr|t l3oo sourlg Fld $120.00itffiagl eJitJmiasoosqurrecct" q40.@
ffi* Eac*r O,lbdldhg / De@tcd G4ra9. S?4.m
Wr.., Erch Swllmhg Pod, Hol tub . - 911030
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Owner a6 detined by RCW- 19.28.261 : ( 1) Owner will occupy the struo'turs for two years aner this eledrical permit as finslized (2) O^'fler is
required to hire an ilectrical contrador iiabove said propeay is for Eale, rent or lease. Peamit expiaes sfter six months qt last insedion'
statement, I he.eby certily that I am the owner of the above named property or a licensed eledtical contraclor' I
Iinstall€tion o. ate;aton i; compliance with the eledricallaws, N.E.C', RCW Chapter 19 28' \ lAc Chapter 2s
468, T c of Port s Municjpal e. and Util ity Specilications and PAMC 14.05.050 regarding Elecirical Pcrmit Applications'
n er
Date Print Name Signature (! f wner Electrical Contractor / Administrator)
OWNER INFORMATION
a
[Electrical Permit Applications may be submitted to city Hall or eleclricalpermits@cityoFa.us or f3xed to 360 417 47111
1-2
1 - 2 SINGLE-FAMILY
TOTAL
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ELECTRICAL CONTRACTOR INFORf\,ATION
PROJECT DETAITS
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