HomeMy WebLinkAbout1221 E 4th St - BuildingCITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N_ 17920
Port Angeles, Washington ------- � - "; 192.
In accordance with the City Ordinance to regulate the installation, extension, or repair of elec-
trical equipment in, on, or about any building or other structure in the City of Port Angeles, per-
mission is hereby granted to do electrical work as listed below.
Address ! °'� 1 - / ------ Occupancy-- - -'rf as.' - -'
-- --- -- ------ -----y/-y //� - -
F %,Q - V ..F'C
Owner '= = ... r" > ----- Tenant ------- ------------- _ ---------
-
WiringContractor - -- ------------------------ -- --- ----- --By-- --- --------- ---------------------------------------------------
Light Outlets -------- . .......................... ...... Service, volts
••{.�..- ^- �...r..Cr.�..... Type of Wiring:
Receptacle Outlets ......_._ .................... No. wires ........ `CS_../....._......%....., -... Armored Cable .................... ........
Dryer, KW----------- ----------- -------------- - - - - -- Size wires..... flJ..U..G'b'j Non - Metallic .......... ....... ...............
......_.
q '- Knob & Tube .. .............................. .
_ ' -.`•
Range, KW ......... ............ ..
------ ....._ - - -. Main fuse .......v ....� -3... d....
Water Heater:
Heat: KW ............ ...............................
Motors: size, volts and phase:
Total
Remarks: ...... ..
Enclosure ......
Type of wiring:
Entrance Cable
Rigid Conduit ......
Metallic Tubing ..
Current transformers:
No. & Size ...............
Ser. No ......................
• ` Sec No.....................
Rigid Conduit ...
Metallic Tubing
Raceway .............
Circuits, Light...........
Utility .................
Heat.. .................
Range ............... ..
Water Heater - --
Motor . --- ------------
Furnace
Total
Permit Fete Treas. Receipt
NOTICE— Current must not be turned on until Certificate of Inspection has been issued. Il work Is to be con-
cealed due notice must be given the Inspector so that work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
Address
Owner
N_ 17920
WiringContractor .................................... _ ................................................................... By............................... ...............................
NOTICE— Current must not be turned on until Certificate of Inspection has been issued. If work is to be con-
cealed due notice must be given the Inspector so that work may be inspected before concealment.
IM Olympic Printers, Inc.
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division /Electrical Inspections
321 East Fifth Street -- P.O. Box 1150 / Port Angeles Washington, 98362
Ph: (360) 417 -4735 Fax: (360) 417 -4711
Date; l .5
1 & 2 Single Family Dwelling
UL ��
* Plan Review Ma Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address; 17_
711(-
Building Square Footage:
Description of above
,
Owner InforrQation
Name; k-1 0 j 0(
Contractor Information
r, f(/A, —)
Name; d r
Mailing Address: tzz I Lf - ++
Mailing Address:
City; State: Zip;
City;
State: Zip;
Phone; Fax:
Phone:
Fax:
License 41 Exp. - 3 701
_
License # I Exo.�G
y
Item
Unit Charge
ty
Total (Qty Multiplied by Unit Charge)
Service/Feeder 200 Amp.
$ 120.00
$
Service/Feeder 201 -400 Amp,
$146,00
$
Service/Feeder 401 -600 Amp
$ 205.00
$
Service/Feeder 601 -1000 Amp,
$ 262.00
$
Service/Feeder over 1000 Amp,
$ 373.00
$
Branch Circuit WI Service Feeder
$ 5.00
Branch Circuit W/O Service Feeder
$ 63,00
$
Each Additional Branch Circuit
$ 5.00
$
Branch Circuits 1 -4
$ 75.00
$
Temp. Service/ Feeder 240 Amp,
$ 93.00
$
Temp, Service/Feeder 241 -400 Amp
$110.00
$
Temp. Service/Feeder 401 -600 Amp.
$149.00
$
Temp. Service/Feeder 60 1 -1000 Amp ,
$ 168,00
$
Portal to Portal Hourly
$ 96.00
$
Signal Circuitl Limited Energy -1 & 2 Family Dwelling
$ 64,00
$
Manufactured Home Connection
$120.00
$
Renewable Electrical Energy - 5KVA System or Less
$102.00
$
Thermostat
$ 56.00
$
Note: $5.OD for each additional T -Stat
NEW CONSTRUCTION ONLY:
First 1300 Square Ft,
$ 120.00
$
Each Additional 500 Square Ft. or Portion of
$ 40.00
$
Each Outbuilding or Detached Garage
$ 74,00
$
Each Swimming Pool or Hot Tub
$110.00
$ Total
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 properly or a licensed electrical contractor. I am making
the electrical installation or alteration in compliance with the electrical laws, N.E.C., ROW. 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.
Signature of�w er�t �trical contractor or electrical administrator: 11 Cash check
/✓ /� 7 ❑ Credit Card #
i -/�3-0
0110112012
T,
a
ao
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -4735
Application Number . . . . .
13- 00000782 Date
7/17/13
Application pin number . . .
054224
DITCH
Property Address . . . .
1221 E 4TH ST
ASSESSOR PARCEL NUMBER:
06-30-00-7-9- 0455 -0000-
Application type description
ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use
FINAL
Property Zoning , . . . . . .
RS7 RESDNTL SINGLE FAMILY
Application valuation , , . .
0
Application deHc
ductless heat pump
Owner
Contractor
OISULLTVAN MARSHA J
BLACK DIAMOND ELECTRICAL,
CCNTR
1221 E 4TH ST
502 SLACK DIAMOND RD
PORT ANGELES WA 983624424
PORT ANGELES
WA 98363
(360) 565 -1035
Permit . ,.. , . . ELECTRICAL
ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . 68,00
Plan Check Fee
.00
Issue Date 7/17/13
Valuation . , . .
0
Expiration Date 1/13/14
Qty Unit Charge Per
Extension
1,00 5.0000 ECH EL -ECH
ADDNT BRANCH CIRCUIT
5.00
1.00 63.0000 ECH EL -R-
BRANCH CIR WO/ SER FEED
63.00
Fee summary Charged
paid Credited
Due
Permit Fee Total 66.00
68.00 .00
.00
Plan Check Total .00
.00 .00
00
Grand Total 68.00
68.00 .00
00
5 0,11 14;:N 4j 1"j�
REPORT ,SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
FINAL
COMMENTS: p1 t
PERMIT WILL EMPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contra_ ctor X Date:
GAXCHANGEIBUILDING
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