HomeMy WebLinkAbout2612 S Washington StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4174735
Application Nuniber ., .
Applicatsion pin number
Property Address
ASSESSOR PARCEI, NUMBER:
Application ts].pe descriplion
subdivision Name
ProperEy use
Property zoning
Application vafualion
21- 00000523 Datse 5 /O3 /2L
859850
2612 S WASI{INGTON ST
05-30 - 10-s-1- 0530 -0000 -
ELESIRICAI. ONLY
RS7 RESDMTL SINGLE !'AMILY
0
Application desc
DHP
Owner
KENNETH F I,ARSEN
25]"2 S WASI{INGTON ST
PORT ANGELES WA 98352
CASCADE EI,ECIRIC & VAC INC
PO BOX 369
PORT I{ADI,OCK IIA 98339
(360) 379-5347
Permi!
Additional desc
Permit Fee
Ia6ue DaEe
ELECTRICA! AI,TER RESIDELiITIAI.,
l. -{ clRcgrTs
?5. oo PIan Check Fee
5/a3/21 valudEion
L0 /30/2r
00
0
ExpiraEion DaEe
Qty Unil Charge Per
BASE FEE
ExEension
?5.00
Fee 6umrnary charged Paid Credited Due
Permit Fee Total
PLan Check Total
Grand Tota]
?5.00
.oo
75 .00
.oo
.oo
.00
00
o0
00
?5.00
.00
75 .00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE DATE:RESULTS:
DITCH
SERVICE
ROUGH.IN
FINAL s|ilq -F @
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature ofowner or Elecrical Contractor X
C:\EXCHANCE\Blill.DlNG
Date
ConEractor
IINSPECTOR:
I
I I
COMMENTS:
ELECTRICAL P ERNTIT APPLICATION
Public lVorks and Utilities Depaltment
:l2l E. 5th Stteet. Pon Angcles. \!r{ 98362
360.4 I 7.47-15 | rvrvra,.citl-olpa.us I clectricalpennits(?cit1,olla.us
u
1\n
N\t
Project Address 2612 S Washington St Port An geles
Project Oescript ;on. altered circuits or ducltess heat pump
6 Single-Family Residential E Duplex / ARU Buitding Square footage
Name Ken Larsen Email
l\4ailing Address 2612 S Washinoton St Port Angles p6eng. 360 908 6903
Name' Cascade Electric & Vac License .cascaevg34dm
Exp iration Date: 01 ll't 12021
Phone. 360 531 0385
Mailing Address. PO Box 369
Email blacktailelite@yahoo.ocm
Unlt Charoe Ouantitv IOlal (Quantity x Unit Charge)
Square Feet
I 500 square
i Deta $74.00
Owner as defined by RCW 19.28.261r (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 certiry 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 Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
413012021 Robert Nordberg
Date Print Name Signature (fJ Owner ! Electrical Contractor /Administrato0
IElectrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa. us or faxed to 360.417.47111
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$s.00
$75.00
$93.00
$ 1 10.00
$149,00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
$r20.00
$40.00
I
$
$
$
$
$
s
$
$
$
$
$
$
$
$
s
$
$
$
$
$
75.00
0075TOTAL
$110.00
I 1 - 2 SINGLE-FAMILY tlo
3
OWNER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401-600 Amp.
Service/Feeder 60'1-1 000 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. Service/Feeder 200 Amp
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp Service/Feeder 60'1-1000 Amp
Portalto Portal Hourly
Signal Circuivlimited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
Only