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Home My WebLink About1527 W 12th St - Building N ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 Application Number 12- 00000369 Date 4/12/12 C s n Application pin number 696033 VJ Property Address 1527 W 12TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -3 -5865 -0000- on your excise tax form Application type description ELECTRICAL ONLY Subdivision Name to the City of Port Angeles Property Use (Location Code 0502) Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Application desc 2 circuit remodel, Space heater and outlets Owner Contractor DAVID L DEBORAH H OLANDER BOTERO SON ELECTRICAL 1 1527 W 12TH ST 940 TAMARACK WAY NC PORT ANGELES WA 98363 PORT ANGELES WA 98362 (360) 417 -5063 (360) 452 -4766 N Permit ELECTRICAL ALTER RESIDENTIAL Additional desc Permit Fee 68.00 Plan Check Fee .00 Issue Date 4/03/12 Valuation 0 Expiration Date 9/30/12 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 El Fee summary Charged Paid Credited Due Permit Fee Total 68.00 68.00 .00 .00 .e.--�\ Plan Check Total .00 .00 .00 .00 I Grand Total 68.00' 68.00 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN F31 17--- 4.!I FINAL *1/7--- COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G: \EXCHANGE \BUILDING N ELECTRICAL PERMIT CITY OF PORT ANGELES 9 360- 417 -4735 Q Application Number 12- 00000369 Date 4/03/12 Application pin number 696033 Property Address 1527 W 12TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -3 -5865 -0000- on your excise tax form Application type description ELECTRICAL ONLY Subdivision Name to the City of Port Angeles Property Use (Location Code 0502) Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Application desc 2 circuit remodel, Space heater and outlets Owner Contractor DAVID L DEBORAH H OLANDER OWNER 1527 W 12TH ST PORT ANGELES WA 98363 (360) 417 -5063 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc Permit Fee 68.00 Plan Check Fee .00 Issue Date 4/03/12 Valuation 0 Expiration Date 9/30/12 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 68.00 68.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 68.00 68.00 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN FINAL COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G: \EXCHANGE \BUILDING CITY OF PORT ANGELES PERMIT APPLICATION J C 1 Building Division /Electrical Inspections El i W 321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362 SOAR 3 0 2(.'• c=7 misty Ph: (360) 417 -4735 Fax: (360) 417 -4711 'F' ELECTRICAL Date: 1 2 Single Family Dwelling INSPECTIONS Plan Review May Be Required, Please Complete Ele ric Pan Review Information Sheet Job Address: 7 if): /;,2 tip 'or iii r° f�-S ljf.22 9's3 4 5 Building Square Footage: 9 Description of above 1�4I7�� C40,cu 0 612_ 1Z At.t.. VI ILAS'V-OZS 4- $\'P I4t 7 I'EIO'I. aU •t Owner Informat)'on Contractor Information Name: ad Ic.G .1�c--'/ h le_ (2lu.,t der Name: Mailing ddress: f P?, )e (62. Mailing Address: City: State:a'a Zip: 1.S."3Z",:2 City: State: Zip: Phone: Fax: Phone: Fax: License Exp. License Exp. Item Unit Charge ON 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 W/ Service Feeder 5.00 Branch Circuit W/O Service Feeder 63.00 ___L- bl Each Additional Branch Circuit 5.00 1 4 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 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 Hot Tub 110.00 tog 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. Signature of owner, electrical contractor or electrical administrator: Cash Check V Credit Card X /04/1 471 0l'1 �ri P.2 Dated: 3/. 3/42 0110112012 ,��i sc)Rr t' h 1 CITY OF PORT ANGELES PERMIT APPLICATION J 1, d Building Division /Electrical Inspections 321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362 APR 1 2 Ph: (360) 417 -4735 Fax: (360) 417 -4711 ='Y" ELECTRICAL Date: `7�-/ }vi V 1 2 Single Family Dwelling INSPECTIONS Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: r> Building Square Footage: Description of above 12 w X2.6 A(_ f1 L m .,.2ci A i. vA.. c -.e Owner Information Contractor Info ation Name: Name: i k c. .i. 56)0 Mailing Address: Mailing Address: q(/t f' v4 V al c (G "Ln1 City: State: Zip: City: r _A State: 6 L Zip: e3 k 1-- Phone: Fax: Phone: 9& i 5i ?5 Fax: '/t Yg6y 4 /74' t'' License Exp. License Exp. ,nT rr /2, 5 C. 3 5. G Item Unit Charge Qty 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 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 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 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 -46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical con ractor or electrical administrator: .Ch Check 7/ f Credit Card L7/+ili"7! X Dated: /-7/ ..;20.1:..;20.1:,2--- r 01101/7'1 RECEIVED APR 12 2012 CITY OF PORT ANGELES BUILDING DIVISION v pORT AN, Backflow Assembly Test Report City of Port Angeles Public Works and Utilities Department Water/Wastewater Collection Division NAME OF PREMISES. c ,P 8 SERVICE ADDRESS y 2 7 tt/ r t .5- 7 Fee LOCATION OF DEVICE. 0 Aye? /�6'1 CA X --7 ASSEMBLY 14T I' L Ili Oa- 3 5 k pRKS ANO Manufacturer Model Size Serial No IS THIS AN APPROVED ASSEMBLY? YES 0-NO IS ASSEMBLY INSTALLED CORRECTLY' YES 0-NO DATE OF INSTALLATION $I,)`. ))P'[t UNKNOWN 0 Initial Test Repairs Details Final Test AIR GAP INSPECTION REQUIRED MINIMUM SEPARATION YES NO COMMENTS Initial Test Repairs Final Test Cleaned Replaced I Date /Time Tester REDUCED PRESSURE PRINCIPLE ASSEMBLY DOUBLE CHECK VALVE ASSEMBLY CHECK VALVE #1 Leaked Held at 2r 4' psi Held at e2 psi CHECK VALVE #2 Leaked Closed Tight 0— Held at 42 ba psi Closed Tight Held at 2 6 psi Signature Replaced Replaced Did Not Open Opened at psi 3 psi Butler YES NO Opened at psi .Jl /t'/ 5/ IR %P Te -re-/ 9` IP/1 r wd Line Pressure Cert. Test Kit psi Official Use Only Assem.# `6 (41 Received RP RPDA DC CUB- DCDA PVB Air Gap SVB AVB RELIEF VALVE PVB /SVB AIR INLET Did Not Open Opened at psi Cleaned Cleaned CHECK VALVE Leaked Held at psi REPAIRS Cleaned Replaced AIR INLET Opened at psi CHECK VALVE Held at psi BACK PRESSURE NO YES TYPE OF HAZARD L 4 4r ,v Held Backpressure YES W NO #2 Shutoff Held YES NO Relief Valve Exercised YES NO Passed Failed .67/ if g it,' ezoriL re-14 02-P(& rr b 'f i l 1iP. )t.0' r 'fq I y' e D Jr /.4. E i WHITE CUSTOMER COPY YELLOW PURVEYOR COPY PINK TESTER COPY L CITY OF PORT:AN.GELES :DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT :BUILDING DIVISION '321 EAST 5TH :STREET PORT ANGELES, WA :98362 Application 'Number .10 00000339 Date 4/08/ :10 Appl'icationspin „number 138189 ,Property 'Address .1527'W,12TH.ST .ASSESSOR 'PARCEL :NUMBER 06 :30 0.0 0 '3 '5865 0000 '.Tenant nbr 'name DAVID 'DEBORAH .OLANDER Application type. description PLUMBING REPAIR Subdivision Name ;Property Use :Property .Zoning RS7.RESDNTL SINGLE FAMILY Application valuation 250 .Application desc INSTALL_A T :DOUBLE_LCHECK VALVE F_OR.aAWN_ :SPRINKLER_ :Owner Contractor DAVID 'L .DEBORAH .H 'OLANDER- :LANDSCAPING BY COCKBURN :INC .1527 W .12TH ,ST -4950 "SEQUIM 'DUNGENESS `:WAY .PORT :ANGELES 'WA :5,8363 :SEQUIN! .r 'WA 58382. (360) 41.7 '5063 (36.0) 681 0132 Permit :PLUMBING, :PERMIT .Additional desc ;DBL -CHK BACKFLOW' :DEVICE :Permit pin 'number :1'63469' Permit Fee :57 '00 Plan .Check .Fee' '00. Issue Date 4/0:8%.10' Valuation :0” -Expirat Date 10 /'05,/10 ,Qty Unit Charge .Per 1 00 7 0000 EA BASE :FEE PL- :LAWN 'SPRNKLR :BC -KFLW' 'PREY .Fee summary 'Charged Paid' <Credi'.ted .Diie 'Permit Fee 'Total :57 0,0 :57 0,0 .00' 0o Plan Check ,Total 00' .00 00' ;00 'Grand Total 5'-7 -00 .57 00 '00 '.00 ;Extension :50.00 '7 00 F 111 6 u. ihsP�G'h.o I ease +o L v1A6L Separate :Permits.are required for.electrtcal'work, SEPIA, 'Shoreline, ESA, utilities,private.andpublid 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 the 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 governingthis .type of work will be complied with whether specified'herein or.not. 'The.granting of a permit 'do o .resume to give authority to .violate or cancel the provisions of.any state or local law regulating construction or, the. performance of constructs ))e) OW yr CC: &,k (1.\ Date Print Signature of,Cb ctor or A on Agent .Signa re-pf Owner (if owner is builder)/ T:FonnsBuilding DivisionBuilding_Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 10 00000339 Date 4/08/10 Application pin number 138189 Property Address 1527 W 12TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 3 5865 0000 Tenant nbr name DAVID DEBORAH OLANDER Application type description PLUMBING REPAIR Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 250 Application desc INSTALL A 1 DOUBLE CHECK VALVE FOR LAWN SPRINKLER Owner Contractor DAVID L DEBORAH H OLANDER LANDSCAPING BY COCKBURN INC 1527 W 12TH ST 4950 SEQUIM DUNGENESS WAY PORT ANGELES WA 98363 SEQUIM WA 98382 (360) 417 5063 (360) 681 0132 Permit PLUMBING PERMIT Additional desc DBL -CHK BACKFLOW DEVICE Permit pin number 163469 Permit Fee 57 00 Plan Check Fee 00 Issue Date 4/08/10 Valuation 0 Expiration Date 10/05/10 Qty Unit Charge Per Extension BASE FEE 50 00 1 00 7 0000 EA PL -LAWN SPRNKLR BCKFLW PREY 7 00 Fee summary Charged Paid Credited Due Permit Fee Total 57 00 57 00 00 00 Plan Check Total 00 00 00 00 Grand Total 57 00 57 00 00 00 Separate Permits are required for 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 fora period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that t 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 do o •resume to give authority to violate or cancel the provisions of any state orr local law regulating construction or the performance of constructi 'Dine Print N e Signature of Chfi r�actor or A ori2151 Agent Signature -of Owner Of owner is builder)/ T.Forms/Building Division/Building Permit Inspection Type 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 I Furnace I 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 I Electrical Construction R W PW Engineering Fire Planning Building T.Forms /Building Division /Building Permit 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 FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE 417 -4735 417 -4831 417 -4653 417 -4750 417 -4815 eacKrtocru P r*- ova Devtce �r L or, Std hKler S FINAL Date 6 -1-I° Accepted by R 6°1 1704 FINAL Date Accepted by SEPA. ESA. SHORELINE. Comments Date Accepted By E cQ CITY OF PORT ANGELES Attn Building Permit Technician 321 E. Fifth St. Port Angeles WA 98362 (360) 417 -4815 fax (360) 417 -4711 Applicant c_-_-‘ v es h� 61;c4 0./A. J.� Coc/ x -tu Property Owner 1, I, 6 .e, V Property Owner's Address 7 (J Contractor L- g C� eAie,«. Contractor's Address i License /6'3 D Z Exph 3 /yA4 E -mail PROJECT ADDRESS /1 9 A) /o Parcel Number Project Type Brief Description. Check all that apply New Construction Addition Remodel Repair Demolition Re -roof Heat System Other Floor Areas Basement 1St Floor 2 Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other Total footprint of structures Site Coverage the amount of impe and other impervious surfaces (s Max. height of proposed structures Will a lawn sprinkler system be installed? Will a fire sprinkler system be installed? T Forn(s /building Division /Building permit applica BUILDING PERMIT APPLICATION Print in ink Residential Multi- family I Udu 1 /,P Cj rc)i (:/f House garage other Heat pump wood- burning stove gas fireplace Existing (sq. ft.) Proposed (sq. ft.) /1 1 1 1/ A 1 sq ft. T Lot size s surface on a parcel including stru MC 17 94 135 for exemptions) ft. Yes Occupancy group Occupant load Construction pe Phone Phone Phone Lot i— TOTAL VALUATION For City Use Only Date Received W %R Permit Date Approved 6i1 ',9077 cf)7— 6 Zoning Commercial Industrial tear off re -roof lay over one layer pellet stove other per sq ft. sq. ft. Lot coverage ved driveways sidewal Site coverage of bedroo of full b s of hal •aths 2 5 o OS /0 I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand that It is my responsibility to determine hat permits are required, and to obtain permits prior to wo ng on projects Date l /NAND Print Name OcC3C.40 Signature /6- Clallam County Assessor Treasurer Property Details 59714 DAVID L DEBORAH Page 1 of 6 Clallam County Assessor Treasurer Property Search Results 59714 DAVID L DEBORAH H OLANDER for Year 2009 2010 Property Account Property ID Geographic ID Type: Tax Area: Open Space. N Historic Property N Multi Family Redevelopment: N Location Address. Neighborhood: Neighborhood CD: Owner Name Mailing Address. i Taxes and Assessments Due 1527 W TWELFTH ST PORT ANGELES Cycle 5 Res 10955130 Property Tax Information as of 04/08/2010 Amount Due if Paid on. Statement l Year ID I Taxing Jurisdiction 12010 42605 ST SCH STATE SCHOOL 2010 42605 2010 42605 ;2010 12010 1 2010 12010 2010 2010 2010 12009 1 2009 2009 1 2009 42605 42605 42605 42605 42605_ 42605 1200_9_597142008_ 2609_591_142008 1 2009 597142008 12009 597142008 59714 0630000358650000 Real 0010 PA 121 PORT ST CNTY H2 L Land Use Code DFL Remodel Property* Mapsco Map ID DAVID L DEBORAH H OLANDER Owner ID: 1527 W 12TH ST Ownership PORT ANGELES WA 98363 CC -GEN COUNTY PORT PORT PORT ANG PORT ANGELES SD #121 SCHOOL DISTRICT #121 NTH OLY LIB NORTH OLYMPIC LIBRARY HOSP #2 HOSPITAL #2 WSMET PK DIST WILLIAM SHORE MET PARK DIST $16 18 $16 19 CITY STORMWATER CITY STORMWATER WEED_CONTROL WEED CONTROL 2010 42605 TOTAL. 597142008 ST SCH STATE SCHOOL 597142008 CC -GEN COUNTY 597142008 PORT PORT 597142008 PORT ANG PORT ANGELES SD #121 SCHOOL DISTRICT #121 NTH OLY LIB NORTH OLYMPIC LIBRARY HOSP #2 HOSPITAL #2 CITY STORMWATER CITY STORMWATER Legal Description. LTS 13 &14 BL 358 Agent Code. Exemptions. 11 N N 43975 100 0000000000% $233 02 $233 01 $0 00 $123 99 $124 01 $0 00 $1743 $1743 $000 $287 12 $287 10 $0 00 First Second Half Half i Base 1 Base i I Base An i Due Due Penalty Interest Paid Du $0 00 $0 00 $0 00 $0 00 $0 00 $0 00 $0 00 $0 00 $E $301 82 $301 82 $0 00 $0 00 $0 00 $F $36 03 $36 03 $0 00 $50 87 $50 87 $0 00 $0 00 $0 00 $0 00 $0 00 $0 00 $36 00 $3600 $0 00 $0 00 $0 00 $0 82 $0 81 $0 00 $0 00 $0 00 $1103.28 $1103.27 $0.00 $0.00 $0.00 $2; $264 63 $264 64 $0 00 $0 00 $529.27 $133 93 $133 $6 60 $0 00 $267 86 $18 97 $18 97 $0 00 $0 00 $37 94 $293 76 $293 76 $0 00 $0 00 $587 52 $327.27 $327.26 $0 00 $0 00 $654 53 $38 91 $38 92 $0 00 $0 00 $77 83 $54 93 $54 92 $0 00 $0 00 $109 85 $36 00 $36 00 $0 00 $0 00 $72.00 http. /vpn.clallam. net. 8084 propertyaccess /Property.aspx ?cid =0 &year= 2009 &prop_td =59714 4/8/2010 Application Number . . . . . 23-00001146 Date 10/25/23 Application pin number . . . 747828 Property Address . . . . . . 1527 W 12TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-3-5865-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Service ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ DAVID L / DEBORAH H OLANDER BLACK DIAMOND ELECTRICAL CONTR 1527 W 12TH ST 502 BLACK DIAMOND RD PORT ANGELES WA 98363 PORT ANGELES WA 98363 (360) 417-5063 (360) 565-1035 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . . Permit Fee . . . . 120.00 Plan Check Fee . . .00 Issue Date . . . . 10/25/23 Valuation . . . . 0 Expiration Date . . 4/22/24 Qty Unit Charge Per Extension 1.00 120.0000 ECH EL-0-200 SRV FEEDER 120.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 120.00 120.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 120.00 120.00 .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:--------------------------------------□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