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CITY OF PORT ANGELES PERMIT APPLICATION RECOVE ,
Building Division/Electrical Inspections
321 East Fifth Street—P.O.Box 1150/Port Angeles Washington, 95362 AFIR
Ph: (360) 417-4735 Fax: (360) 417-4711
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Date: Multi-Family or Commercial* KPFCT.10
* Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: I'S0 2
Building Square Footage:
Description of above
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Owner Information Contractor Information
Name: 1 0 Name:
Mailing Address; Mailing Address:
City: !?1 Stai� Zip: City: State: Zip:
Phone: !j1Z!-l�?. Fax: q1Z. x`71! Phone: Fax:
License#/Exp. License#I Exp,
Item Unit Charge Qty Total(QtX Multi�pl%y Unit Charge)
Service/Feeder 200 Amp. $132.00 $
Service/Feeder 201400 Amp, $160.00 $
Service/Feeder 401-600 Amp $225.00 $
Service/Feeder 601-1000 Amp, $288.00 $
Service/Feeder over 1000 Amp. $410.00 $
Branch Circuit WI Service Feeder $ 5.00 $
Branch Circuit WIO Service Feeder $ 74.00 $
Each Additional Branch Circuit $ 5,00 $
Branch Circuits 1-4 $ 86.00 $ _
Temp.Service/Feeder 200 Amp. $102.00 $
Temp.ServicelFeeder 201-400 Amp. $121,00 $
Temp.Service/Feeder 401-600 Amp. $16400 $
Temp,Service/Feeder 60 1-1000 Amp. $185.00 $
Portal to Portal Hourly $ 96.00 $
Sign/Outline Lighting $ 88,00 $
Signal Circuit]Limited Energy-Multi-Family $ 64.00 $
Signal Circuit/Limited Energy/First 1500 sf-Commercial $ 96.00 $
Note: $5,00 for each additional 1500 sf
Renewable Electrical Energy-5KVA System or Less $113.00 $
Thermostat $ 56.00 $
Note:$5,00 for each additional T-Stat —�
$ Z 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 296-4613,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
El Credit Card
X Gated: 01!0112012
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number 14-00000432 Date 4/15/14
Application pin number . , , 236400
Property Address . , , . . , 1802 L ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06 30-00-1 1-0700-0000-
Application type description ELECTRICAL ONLY on your excise fax form
Subdivision Name . . . . . . to the City of Port Angeles
Property Use
Property Zoning , . . , , . , RS7 RESDNTL SINGLE FAMILY (Location Code 0502)
Application valuation . . . . 0
Application dept
200 amp service repair
Owner Contractor
CITY OF PORT ANGELES OWNER
PO BOX 1150 '�-
PORT ANGELES WA 983620217
(360) 417-4532
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Permit . . . . . , ELECTRICAL ALTER COMMERCIAL,
Additional desc • •
Permit Fee 132.00 Plan Check Fee 00
Issue Date 4/15/14 Valuation 0
Expiration Date 10/12/14
Qty Unit Charge Per Extension
- 200 SRV FEEDER 132.00
- ----------------- �-�
1.00 132.0000 ECH FL-C M
Fee Summary Charged Paid Credited Due
----------------- ---------- -------
Permit Fee Total 132.00 132.00 .00 •00
Plan Check Total .00 •00 •00 •00
Grand Total, 132.00 132.00 •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:
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