HomeMy WebLinkAbout914 S D St - Building
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N?
15189
e,' C
Port Angeles, washington__m___m_l_m:=:____L_I__m_muumumm, 19)f
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 ___~~___.m~~.uu__.u. Occupancy_._m._m__m__m____m__________nn____n
owneLt!._?imnL<:/--um_mSJ).m_J:J_m.stTenant..._nm___nm___nmm_m_m_m_mm______m____mn___nnu
Wiring Contractor ___0.N::::X-:'!...j!uq_m_uu_m__u___________h__ Byn__u_m________.hu__hmm_h_n__h__h__u_____umh____h_
Light Outlets_____...__.______...____...____________.. Ssrvice, volts ...!..7.,___Q_:~__.2__Y..__:r::, T,.pe of WIring:
Receptacle Outlets__...m.....h..........__..__ No. wires ..__...........~m.m__m____m Armored Cable ------ ...mm..m__..__...
D'Ter, KWI_m____m_n_____.__h__.______.________ Size wlres____'jf,4___.L~1."",,'h' Non-Metallic hh....h_h...............____.
/7. Knob & Tube...m____m.....m.............
Main fuse ......;..._...~....n.....__
Ran,ge, KW.._.........__..._.
Rigid Conduit ..__.m.....m.mm.m....
Wa.ter Heater:
Enclosure m.h......hmmm.mm.m.....
'l'ype of wirIng:
Entrance Cable __m__m________....m....
Metallic Tubing ........__h...........__..
Raceway ....____.....__.......______.__.h__......
KW.n.h.__mmnmn___ __mmm__mm__
Ileal' RW..__h__!--'I)......K)../-),
Rigid Conduit "'__'__'___h____.............
Circuits, LfghLm.__..mm.........__h..m.....
Utility ____h...__.....h...........................
Motors: size, volts and phase:
Metallic Tubing ............h...h......h
Current transformers:
No. & Size......__h__.mm..m.......__......
Heat
Ser. No.........._._...__..__....__..____.__...__...
Range ..____.....__..__....__...____........______.
Water Heater __.............................
Motor ..._.....................__..........__.....
Ser. NO.....h..............h.........__..h.____....
Dryer...........______..__......____....__......__..._
Furnace .....h..................._m...m__.......
Ser. NO.....................h........................
Total Load....m..mm..__..........
Scr. No.........______.___..............__.__.____..
Total.......................................
Remarks: .m.___n.n___nn___nm_...m.u_m.__.mhmmu____umh__h._nm__.mm__uhU..UUn_nm__.mm_nmumh.h_h_m.n___u.m
nn___.mn____nn._.m~l1<.c.."'~&~l--h.>.S:..d.d:~.hL-nn-m.m*.h.hilYL_tc.rd.__rJ._.-.Bmh________nn
. I
/,( ) ,
By u_mm...~m'''.I~nn-n.mn.----mmmm.
NOTICE-Current must not be turned on until Certificate of Inspection has been issuei:1. If 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
Permit Fee
$.__m__m______m_________________.
Treas. Receipt
NO.__...___.___...___m__..____
2.. 0 0 1\' ~.
J 0 J(l,-J, (}13
ELECTRICAL PERMIT
N?
15189
Date callefio'"le/tlon.------~h--h--.B--h--i!-f!.~--.........-------...--..----h...----------t;--~-.h,lV-..:-...hI'i
~::~~::a~:~::~:~.~~~:~;~~'~:---~~:~::-:::::::-::::::::::::-.:::-:::::::-:::::::::::::::::::::::?:~::::~;:;:~:::::::~:::::::~
Total wad nnh..n.hn..nhn.................hnh..hnnunnnunn.....u...........n" .n.n."..""__."n.n..'
1M 3-72 Olympic Printers, Inc.
PREPARED 11/12/10 9 03 10
CITY OF PORT ANGELES
ADDRESS
TENANT NBR
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99
0
914 D ST
WILLIAM RAYMOND JANIS
EVERWARM INC
WILLIAM JANIS AND
06 30 00 0 3 0290 0000
10 00001210 MECHANICAL APPL
JLL
MECHANICAL FINAL TIME 01 00
November 9 2010 3 32 3S PM 1pangrle
BILL 206 276 4307
MECHANICAL FINAL WOOD- BURNING STOVE
AFTERNOON
PLEASE CALL HIM 10 MINUTES BEFORE YOU GET THERE
INSPECTION TICKET
INSPECTOR JAMES LIERLY
PERMIT
SUBDIV
PHONE
PHONE
OMMENTS AND NOTES
(360) 452 3366
(206) 276 4307
PAGE
DATE
e'
R\e/35e �11 yo q�{'�PKY
e(\
1
11/12/10
.J
Application Number 10 00001210
Application pin number 996520
Property Address 914 D ST
ASSESSOR PARCEL NUMBER 06 30 00 0 3 0290 0000
Tenant nbr name
Application type description MECHANICAL APPL PERMIT
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
INSTALL A WOOD BURNING STOVE
Owner
WILLIAM JANIS AND
RAYMOND F JANIS
PO BOX 31221
SEATTLE
(206) 276 4307
Qty Unit Charge
1 00
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES WA 98362
10 6500 EA
10 h r1 1 0
Date Print Name
T Forms /Building Division /Building Permit
WA 98103
'er
60 65
00
60 65
RS7 RESDNTL SINGLE FAMILY
4100
t G
WILLIAM RAYMOND
Contractor
EVERWARM INC
257151 HWY101
PORT ANGELES
(360) 452 3366
Permit MECHANICAL PERMIT
Additional desc IMTALL A WOOD BURNING STOVE
Permit pin number 17!786
Permit Fee 60 65
Issue Date :.0/19/10
Expiration Date 4/17/11
Charged Paid Credited
Date 10/19/10
JANIS
WA 98362
Plan Check Fee 00
Valuation 0
BASE FEE
ME STOVE /FIREPLACE /MISC APP
60 65 00
00 00
60 65 00
Due
Extension
50 00
10 65
00
00
00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
Separate Permits are required fo electrical work SEPA, Shoreline, ESA, utilities private and public improvements This permit becomes
null and void if work or construction authorized is not commenced within 180 days if construction or work is suspended or abandoned
for a period of 180 days after thei work has commenced, or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to iiolate or cancel the provisions of any st or loc lating construction or the performance of
construction.
L
Signature of Contractor or Auth Signature of Owner (if owner is builder)
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 -4815 Electrical Inspections 417 -4735
Public Works Utilities 417 -4831 Backflow Prevention Inspections 417 -4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water
AIR SEAL.
Walls
Ceiling
FRAMING
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Slab
Wall Floor Ceiling
MECHANICAL.
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT Separate Permit #s
Parking Lighting i
Landscaping
Inspection Type
Electrical 417 -4735
Construction R W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
T.Forms /Building Division /Building Permit
(FINAL Date Accepted by
FINAL Date it by
SEPA.
ESA.
SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date Accepted By
zs
C
Applicant or Agen' \I u„,
Owner 'V/ +crvi „,s
Owner's Address t y s 0 s o
Contractor /Engineer if t/ ',ew4 -rzA4
f- ontractor /Engineer's Address .„1
License „i /0"',2 gNc_-
PI ADDRESS
arcel Number
arcel
Project Type Brief Description.
Check all that apply
New Construction
o Addition
o Remodel
o Repair
o Re -roof
Demolition
o Sign
o Heat System
o Other
Max. height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be instlled?
BUILDING PERMIT
CITY �OF PORT ANGELES
Attn Buil Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
h
q;/ 5 D 5T
sit "I Ak4, elf Jf
tesidential
Total footprint of structures I sq ft. Lot size
ft.
t/ +`2o..l
Floor Areas Existing (sq. ft.. Proposed (sq. ft.)
Basement
1st Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Occupancy group
Occupant load'
Construction type
APPLICATION Print in Ink
ya3G3
Phone
Phone
Phone
PA-, 60 eu
Expires
Doc" Avic jo9 3
Lot
o Commercial Multi- family
o wall- mounted o projecting o freestanding o awning
Total sign area sq. ft. Maximum allowed sign area sq
o Heat pump Kwood- burning stove o gas fireplace pellet stove other
I have read and completed this application and know it to be true and correct. I am aut
understand that it is my responsibility to determine what permits are required, and
Print Name
Date 1/1 1/ i `G G I c. Signatu
1 7/1 0 V`
T.Forms /Building Division /Bldg Permit Appl 2006 Code doc
TOTAL VALUATION 'Cl/00-0
sq ft. Lot coverage
For City Use Only
Date Received 10 I9-
Permit i 0 ►,21A
Date Approved
-t :R _33 C
g//7///
Zoning
per sq ft.
ft.
of bedrooms
of full baths
of half baths
o Industrial
other
to apply for this permit and
n permits orior to working on
Clallam County Assessor Treasurer Property Details 58964 WILLIAM JANIS AND Page 1 of 6
Clallam County Assessor Treasurer
Property Search Result? 58964 WILLIAM JANIS AND RAYMOND F JANIS for Year 2010 2011
Property
Account
Property ID:
Geographic ID:
Type
Tax Area.
Open Space:
Historic Property
Multi Family Redevelopment
Township
Range
Location
Address.
Neighborhood
Neighborhood CD:
Owner
Name.
Mailing Address.
Taxes and Assessment Details
Property Tax Information as of 10/19/2010
Amount Due if Paid on.
2010
2010
2009
2009
2009
2009
N
589642008 PORT ANG PORT ANGELES
2009 589642008 _PORT
#1 ?1 SCHOOL DISTRICT #121
58964 Legal Description. N2 LOTS 18 -20 BL
302 MAP 1-5
0630000302900000
Real
0010
N
N
PA 121 PORT ST CNTY H2 L Land Use Code
DFL
Remodel Property:
914 S D ST
PORT ANGELES WA 98362
Cycle 5 Res
10955130
Agent Code.
Section
Mapsco
Map ID*
WILLIAM JANIS AND RAYMOND F JANIS Owner ID:
PO BOX 31221 Ownership
SEATTLE, WA 98103
(Year Statement ID Taxing Jurisdiction
2010 41876 ST SCH STATE SCHOOL
2010 41876 CC -GEN COUNTY
2010 41876 PORT PORT
2010 41876 PORT ANG PORT ANGELES
2010 41876 SD #121 SCHOOL DISTRICT #121
2010 41876 NTH QLY I LIB NORTH OLYMPIC LIBRARY
2010 41876
2010
First Second
Half Half
Base Base
Exemptions.
Amt. i Amt.
$155 45 $155 45
$82.72 $82.73
$11 62 $11 63
$191 54 $191 _53
$201 35 $201 34
$2404 $24 04
$18 93
41876 WSM9T PK DIST WILLIAM SHORE MET PARK DIST $10 80 $10 80
41876 CITY_STORMWATER CITY STORMWATER
41876 WEED i CONTROL WEED CONTROL
2010 41876 TOTAL.
589642008 ST S STATE SCHOOL
589642008 CC -GI=N COUNTY
589642008 PORT PORT
11
N
N
3
193333
100 0000000000%
NOTE If you plan to submit payment on a future date make sure you enter the
click RECALCULATE to obtain the correct total amount due
Penalty Interest i Base Paid A
$0 00 $0 00 $155 45
$0 00 $0 00 $82 72
$0 00 $0 00 $11 62
$0 00 $0 00 $191 54
$0 00 $0 00 $201 35
$0 00 $0 00 $24 04
$0 00_$0 00 $33 94
$0 00 $0 00 $10 80
$36 00 $36 00 $0 00 $0 00 $36 00
$0 82 $0 81 $0 00 $0 00 $0 82
$748.28 $748.26 $0.00 $0.00 $748.28
$118 17 $178 95 $0 00 $0 00 $297 12
$59 82 $90 56 $0 00 $0 00 $1 5 0 38
$848 $12.82 $0 00 $0 00 $21 30_
$130 95 $198 41 $0 00 $0 00 $329 36
$144 33 $219 55 $0 00 $0 00 $363 88
http.//vpn.clallam.net.808 lipropertyacces s /Property. aspx ?c id =0 &year= 2010 &prop_id =5 10/19/2010
PREPARED 4/01/09 8 42 07 INSPECTION TICKET PAGE 12
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 4/01/09
ADDRESS 914 D ST SUBDIV
TENANT NBR RAYMOND F JANIS
CONTRACTOR CHARLES BURNELL HOME REPAIR PHONE (360) 452 4094
OWNER RAYMOND F JANIS PHONE
PARCEL 06 30 00 0 3 0290 0000
APPL NUMBER 09 00000203 RES REPAIR
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL99 01 4/01/09 JLL BLDG FINAL
1) March 31 2009 11 12 14 AM 1pangrle
--y CHARLES 452 4094
BLDG FINAL
PLEASE INSPECT AS SOON AS POSSIBLE
COMMENTS AND NOTES
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
REPAIR INSECT DAMAGE IN CRAWL SPACE /FNDTN OF HOME
Owner
RAYMOND F JANIS
3690 WINDSOR CIRCLE NE
CLEVELAND TN 37312
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per
8 00 14 0000 THOU BL -2001 25K (14 PER K)
Other Fees
T:Forms/Building Division/Building Permit
CITY OF PORT ANGELES
DEPARTME\IT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES WA 98362
BUILDING PERMIT
INSECT DAMAGE TO
14489
207 75
3/11/09
9/07/09
09 00000203
192865
914 D ST
06 30 00 0 3 0290 0000
RAYMOND F JANIS
RES REPAIR
RS7 RESDNTL SINGLE FAMILY
9050
BASE FEE
Contractor
CHARLES BURNELL HOME REPAIR
PO BOX 3023
PORT ANGELES
(360) 452 4094
RESIDENTIAL
HOME FNDTN
STATE SURCHARGE
Plan Check Fee
Valuation
Fee summary Charged Paid Credited
Permit Fee Total 207 75 207 75 00
Plan Check Total 135 04 135 04 00
Other Fee Total 14 50 4 50 00
Grand Total 347 29 347 29 00
Date
void if work or construction authorized is not commenced within 180 days, if construction
after the work has commenced, or if r i nspections have not been reque
read and examined this application and know the same to be true and c• t.
be complied with whether specified herein or not. The granting of ..y� u;
state or local law regulating construction or the performance o ��1 s��. if/ 40111.°
3/11/09
WA 98362
Sh09 aarki
Date Print Name Signature of Contractor Authorized Agent
135 04
9050
Extension
95 75
112 00
4 50
Due
00
00
00
00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and
r work is suspended or abandoned for a period of 180 days
days from the last inspection. I hereby certify that I have
of laws and ordinances governing this type of work will
o give authority to violate or cancel the provisions of any
Signature of Owner (if owner is builder)
FOUNDATION
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs
PLUMBING
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water
AIR SEAL.
Walls
Ceiling
FRAMING
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION
Slab
Wall Floor Ceiling
MECHANICAL.
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 4815 Electrical Inspections 417 4735
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I ESA.
Landscaping I SHORELINE.
FINAL Date Accepted by
FINAL Date Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type I Date Accepted By
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4,750
Building 417 -4815 I i4 lot I Oct Pg
I I
T.Forms /Building Division /Building Permit
°u'w B BUILDING PERMIT APP LICA TI ON itik
In Ink 3
crr OF PORT ANGELES
Attn. Building Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
Applicant C'!>a! /es Mme, Pho
Property Owner °k" jam,,,,, S Phone
Property Owner's Addrdss 9i11 S 1), sq, Y}, /9 E,Ja
Contractor C42rle.5 ell Awe Akiir Phone
Contractor's Address 3 5J ,S, 71,40)- 7W, /tee AM, 9 Y4.3
/,I
License e Mte#9.330 Expire o9 /43 /o9' E -mail
PROJECT ADDRESS 9 A ek5, /Jq
Parcel Number Lot
Project Type Brief Description. p4Residential Multi family
.oto4 4 75) Attee dorigole ebriol etxi f
o6 'J.0 406dsv,&am< 1 ex:1)440a 'mJl
aciatilkif 014.e
Check all that apply
New Construction
Addition
Remodel
(Repair
Demolition
Re -roof
Heat System
Other
Floor Areas
Deck
Shed
Other
House garage other tear off re -roof lay over one layer
Heat pump wood- burning stove gas fireplace pellet stove other
Existing (sq. ft.) Proposed (sq. ft.)
Basement
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
-I lt y)
r iv
Total footprint of structures f sq ft. T Lot size
Site Coverage the amount of impervious surface on a parcel including structures
and other impervious surfaces (see PAMC 17 94 135 for exemptions)
Max. height of proposed structures ft Occupancy group
Will a lawn sprinkler system be installed? Occupant load
Will a fire sprinkler system be ins ailed? Construction type
I have read and completed this applhation and know it to be true and correct. I am authori
that it is my responsibility to determir e at permits are required, and to obtain permits p
es e /718 Signat
DateS Print Nam
T Forms /B iding Division /Bldg Permit.da;
For City Use Only
Date Received O3
Permit O
ate Approved 91
Commercial
v5a
4//502 -L/v9-9
Zoning
per sq ft.
TOTAL VALUATION 2
sq ft. Lot coverage
paved driveways sidewalks
Site coverage
of bedrooms
of full baths
of half bath
Industrial
patios
understand
1
I
r
y. r.. T
0
as
i
//4
c l rF S LAB
f
ab
Approval Date
9j, y
t
w
CITY OF PORT ANGELES Construction Plans
The Issuance of this permit based upon these plans. specifi-
cations and other data shall not prevent the building official
from thereafter requiring the correction of errors in said
plans, specifications and other data, or from preventing
building operations being carried on thereunder when in
violation of all codes and ordinances of this jurisdiction.
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Application Number . . . . . 24-00000582 Date 6/13/24
Application pin number . . . 727426
Property Address . . . . . . 914 D ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-3-0290-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
DHP
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
WILLIAM JANIS AND BLACK DIAMOND ELECTRICAL CONTR
RAYMOND F JANIS 502 BLACK DIAMOND RD
PO BOX 31221 PORT ANGELES WA 98363
SEATTLE WA 98103 (360) 565-1035
(206) 276-4307
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 95.10 Plan Check Fee . . .00
Issue Date . . . . 6/13/24 Valuation . . . . 0
Expiration Date . . 12/10/24
Qty Unit Charge Per Extension
1.00 95.1000 ECH EL-R- BRANCH CIR 1-4 95.10
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 95.10 95.10 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 95.10 95.10 .00 .00
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 | www.cityofpa.us | electricalpermits@cityofpa.us
EL1-2 SF 1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION
Project Address:
Project Description: □Single-Family Residential □ Duplex / ARU Building Square footage:
OWNER INFORMATION
Name: Email:
Mailing Address: Phone:
ELECTRICAL CONTRACTOR INFORMATION
Name: License:
Mailing Address: Expiration Date:
Email: Phone:
PROJECT DETAILS
Unit Charge Quantity Total (Quantity x Unit Charge)
$190.20 $
$190.20 $
$285.30 $
$380.40 $
$475.50 $
$5.30 $
$95.10 $
$47.55 $
$95.10 $
$95.10 $
$190.20 $
$285.30 $
$380.40 $
$95.10 $
$95.10 $
$190.20 $
$190.20 $
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401-600 Amp.
Service/Feeder 601-1000 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 601-1000 Amp.
Portal to Portal Hourly
Signal Circuit/Limited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5.30 for each additional)$95.10 $
First 1300 Square Feet $190.20 $
Each Additional 500 square feet``$47.55 $
Each Outbuilding / Detached Garage $95.10 $
Each Swimming Pool / Hot Tub $190.20 $
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-
46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Date Print Name Signature (□Owner □Electrical Contractor / Administrator)
Pe
r
m
i
t
#
:
New
Construction
Only
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417.4711]