HomeMy WebLinkAbout423 W 16th St - Building
-1-<///
FEE RECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
/D7(P
/!f:::./
PERMIT NUMBER
A
.
- tea
TOTAL FEE :J?,OV
CONT. LIe. NO.. TIME TO COMPLETE NO. STORIES LEGAL OCCUPANCY
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
~A.
q'z. 3 ~/~?3 UJA-. C;g.] '-z:..-
~ CORRECT ADD 5 IS RESPONSIBILITY OF APPLICANT PERMITS WITH WRONG ADDRESSES ARE CANCELLED
Owner 12.- Installation By 5"- ( 12
Owner-sAddress 4? 3 ~ )'L-".... Installers Address 5~1k.c.-
Day Phone .</.5/-3:1 "i I.. I<:~T.?_2.-7 011.2.,'/ Installers Phone .'7"r7 - _"'50"l
App.licati~n is herepy made f9r Permit to i~stall Electrical Equipment as follows: a.. J') f) 7 (' j tl ('
Site Address
o
itir..
Wiring Method
.,.
NUMBER AMP .120V 240V NUMBER AMP 120V 240V
USE OF CIRCUIT CIRCUITS PER 10 100R FEE USE OF CIRCUIT CIRCUITS PER 10 100R FEE
CIR 30 CIR 30
LIGHT I SIGN
LIGHT I 50 VOLTS I
OR LESS
CONVENIENCE I MOTOR
CONVENIENCE I -. MOTOR
APPLIANCE MOTOR
DISHWASHER FIRE AL~AMS
DISPOSAL BURGLAR ALARM
RANGE MISC.
OVEN /l.. I,J, ~_ I
WATER HEATER
LAUNDRY
DRYER REINSTALLATION LIGHT FIXTURE #
FURNACE SUB TOTAL FEE
GAS - OIL
FURNACE ENERGY FEE
ELECTRIC '.
BASIC FEE
ELECTRIC HEAT .,. ..
TOTAL FEE
ElECTRIC HEAT , SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
A.C. UNIT AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
--
SERVICE AW.G.
I SUB-TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH
I certify th-at the work to be performed under this permit will be done by the installer and in conformance with the N.E.C. Electrical Code.
Date Application made
~. /., -27
,19 f"7
By
\
~
CTOA OR OWNER (OA AUTHORIZED AGENT)
Permission is hereby given to do the above described work, according to the conditions hereon and according to the approved plans and
specifications 'pertalning thereto, subject to compliance with the Ordinances of the ~i~y)of Port Angeles. . '. ....' \;~
. ~ .D;Z:RECTOR F CITY LIGHT .
.By d~ ~
Date Permit Issued , . .,' PLANS APPROVED
y'fi./?7
I WARNING I
Notify Department of City light by Street Address and Permit Number when ready for inspection. Work must not
be covered or.current turned on before inspection and O.K. for covering or service has been given by Inspector in
Writing on Permit Placard. A.. Permits Phone: 457.0411 Ext. 158.
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER -
WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
(\l.vu.mc: PR1NTFRR INr._
REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
, "
, '. .."\
..
'. ,,, .. .'
.-
" ,
,
,
.
.' "
,
,
,
,
. '. . ,', ,
I . ! ., , ,
4 i{ /P f.X'1 N '.(t(. ,
z' ' O.K. FOR COVERING
, I I . "
'~OCON~EfWlCO_
/ /' ", '/}./I.U;.) ,(I:1'i.tY!....cl N A L
,/ ,f1IiAC~IC" ,
,
'" .. ';,0 ,(f.qI/ErM loin ( ~,/rc!)\ '. '
~~..- ... fi /./~
. I , . "- ,
.,
z
Cl
a:
<I:
~
!!!
:J:
I-
Z
W
~..
~ '
l-
e
z
e
c
e)
RECEIVED
lac �atsr �ry��
CITY OF PORT ANGELES PERMIT APPLICATION MAR 3 ® 201
Building DivisionlElectrical Inspections ELECTRICAL
321 East Fifth Street -- P.O. Box 11501 Port Angeles Washington, 98362 INSPECTIONS
Ph: (360) 417 -4735 Fax: (360) 417 -4711
Date:
1-7 �, _ 18, 2 St a Family Dwelling
k Plan Review May Be Required, Please Com pbX Electrical Plan Review Information Sheet
Job Address: V 7=- i j _
Building Square Footage:
Description of above
Owner Information Contractor Information
Nam Name:
Mailing Address: " 45 T_ Mailing Address:
Clf : State: kLI tA- Zip: City: State: Zip:
Phone: Fax ?.S rri�',� °1 �� c �, Phone: Fax:
License # I Exp, License # 1 Exp
Item Unit Charge Total Multi Q110 by Unit Charge)
ServicelFeeder.200Amp, $120.00 j -- $ $a
ServicelFeeder 201 400 Amp, $146.00 $
Service /Feeder 401 -600 Amp $ 205.00 $
ServicafFeeder 601 -1000 Amp. $ 262.00 $
Service/ /Feeder over 1000 Amp. $ 373,00 $
Branch Circuit WI Service Feeder $ 5.00 $
Branch Circuit W10 Service Feeder $ 63.00 $
Each Additional Branch Circuit $ 5,00 $
Branch Circuits 1-4 $ 75.00 $
Temp. Service/ Feeder 200 Amp, $ 93.00 $
Temp. Service /Feeder 201 -400 Amp. $110.00 $
Temp. Service/Feeder 401 -600 Amp. $149,00 $
Temp. ServicelFeeder 601 -1000 Amp . $168.00 $
Portal to Portal Hourly $ 96.00 $
Signal Circuit/ 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: $5,00 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 Hat Tub $11000 $
$� 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 property or a licensed electrical contractor, I am making
the electrical installation or alteration in compliance with the electrical laws, KIEL,, RCW. Chapter 19,28, WAC, Chapter 296 -46B, The City of Port
Angeles Municipal Cede, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications,
Signature of owner, electrical contractor or electrical administrator: ❑ Cash ❑ Check
❑ Credit Card 9
X Dated: 0110112012
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
Application Number , . . . .
15- 00000314 Date 3/31/15
Application pin number . . .
250498
Property Address . . , .
423 W 16TH ST
ASSSSSQR PARCEL, NUMBER:
06 -30 0`0 -0 -4- 2485
Application type type description
ELECTRICAL ONLY
Subdivision Name . . , . . .
Property Use
Property Zoning . .
ROUGH-INS
Application valuation . . . .
0
-----------------------------------------------------------------------------
Application deac
Service repair
Owner Contractor
------------------------
HOWARD E /LILTA S LACY OWNER
607 W 13TH ST
PORT ANGELES WA 9$3627507
Permit , , . . , . ELECTRICAL ALTER RESIDENTIAL
Additional deSc . .
Permit Fee 120.00 Plan Check Fee .00
issue Date 3/31/15 Valuation . . , 0
Expiration Date 9/27/15
Qty Unit Charge Per Extension
I -Do 9.20.0000 ECH 'EL -0 -200 SR:V FEEDER 120.00
Special Notes and Comments
March 30, 2015 2;46:44 PM Tpeppard,
Service shall comply with NEC, WAC and City service
requirements, Plea Se contact Trent Peppard if you have any
questiona.
Fee summary Charged Paid Credited Due
Permit Fee Total 120.00 120,00 40 .00
Plan Check Total 00 ,00 .00 Do
Grand Total 120,00 120.00 00 .00
REPORT SALES TAX
on your excise tax form
to the City of Part Angeles
(Location Code 0542)
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH-INS
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date;
G:IEXCHAINGEIBUILDING