HomeMy WebLinkAbout1135 W 16th St - Building
Installed By:
CITY OF PORT ANGELES
LIGHT DEPARTMENT
PERMIT NO.
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AwILL CALL FOR
INSPECTION
Phone:
.-
ELECTRICAL PERMIT
DATE
Site Address:
o READY FOR
INSPECTION
License Number:
Owner/Business:
Phone:
Owner/Business Address:
Sq. Ft.
~ Residential /
Heat KW I
o Baseboard 0 Furnace/Boiler
o Heatpump D(Other
o Commerciallindustrial load
Total Connected load
(attach breakdown)
Total Motor load
(attach breakdown)
o New Construction
o Remodel
o Service update/alter/repair
l8: Overhead
o underground;':;yO
Voltage 120:.:t
~ ~
l 10 030
ervice size ~ Amps
o Temporary
o Add/alter circuits
o Auxiliary power
(list below)
o Special equipment
(list below)
Detai IslDescrlption:
~
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~
W.S. No. Service Size
Capacity: 0 O.K. 0 Not O.K. Comments
o Ditch inspection O.K.
1I"'l'fJ..Rough-in/cover O.K.
'", '@ O.K. to connect service
\-rp.FinaIO.K.
\
'Site Address:
\ W.
Date
Hold for: 0 Easement 0 Letter
o Signed up for service/meter
o Meter Department notified for installation
o Fire Department notified of inspection
o Plan Review approved/pending
\staller:
\ 0
,rlify the Departm t of City Light by Street Address and Permit Number when ready for i spection. Work
\.../t not be covered or electrically energized before inspection and O.K. for covering or service has been given
Ie Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 1.?ll. or EXT. 224.
L5 ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT to ~
\ .tnspector A ount paid
\ file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
INTERS. INC.
.J'
Permit/Receipt No.
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Application Number . . . . . 22-00000832 Date 7/08/22
Application pin number . . . 581120
Property Address . . . . . . 1135 W 16TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-4-3140-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
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Application desc
Floor heat
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Owner Contractor
------------------------ ------------------------
DENNIS ROBERT A A1 ROCKHOLD ELECTRIC INC
1135 W 16TH ST 123 WADSWORTH DR
PORT ANGELES WA 983637039 SEQUIM WA 98382
(360) 775-2126
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Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . . 1-4 CIRCUITS
Permit Fee . . . . 75.00 Plan Check Fee . . .00
Issue Date . . . . 7/08/22 Valuation . . . . 0
Expiration Date . . 1/04/23
Qty Unit Charge Per Extension
BASE FEE 75.00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 75.00 75.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 75.00 75.00 .00 .00
1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION
Pub! ic \Yorks and ULili ties Department
32 l E. 5th Street. Port ;\ngeles. WJ\ 98362
300.417.47]5 ! www.cilyofjJa us I electricalpcnnitsr21/cityofpa.us
Project Address:--------------------------------------
Project Description:--------------------------------------â–¡Single-Family Residential D Duplex/ ARU Building Square footage: _______________ _
OWNER JNFORMATtON
Name: ________________________ Email: ______________ _
Mailing Address: ________________________ Phone: ___________ _
ELECTRfCAL CONTRACTOR fNFORMATION
Name: ___________________________ License: ___________ _
Mailing Address: ________________________ Expiration Date: ________ _
Email: Phone: ___________ _
PROJECT DETAILS
Item Unit Charge Qy51ntit3£ :To1s.l (Quantity x 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 W/ 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 200 Amp. $93.00 $
Temp. Service/Feeder 201-400 Amp. $110.00 $
Temp. Service/Feeder 401-600 Amp. $149.00 $
Temp. Service/Feeder 601-1000 Amp. $168.00 $
Portal to Portal Hourly $96.00 $
Signal CircuiULimited Energy - 1 &2 DU. $64.00 $
Manufactured Home Connection $120.00 $
Ren ewable Elec. Energy: 5KVA System or less $102.00 $
Thermostat (Note: $5 for each additional) $56.00 $
First 1300 Sql;Jare Feet $120.00 $
Each Additional 500 square feet" $40.00 $
Each Outbuilding / Detached Garage $74.00 $
Each Swimming Pool/ 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 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.
Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us]
'"'CJ CD
PREPARED 7/06/22, 7:06:59 PAYMENT DUE
CITY OF PORT ANGELES PROGRAM BP820L
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APPLICATION NUMBER:22-00000832 1135 W 16TH ST
FEE DESCRIPTION AMOUNT DUE
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ELECTRICAL ALTER RESIDENTIAL 75.00
TOTAL DUE 75.00
Please present reciept to the cashier with full payment
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
COMMENTS:
Floor heat
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
7/8/2022 22-832 TAP
OWNER
CONTRACTOR
A1 Rockhold Electric
PROJECT ADDRESS
1135 W 16th St