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Home My WebLink About628 E 11th St - Building f pORT ~ ~...O~~ "~." "-~ ~ 'l.t>:~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property zoning . . . Application valuation 04-00000388 Date .154400 628 E 11TH ST 06-30-00-0-3-3810-0000- ELECTRICAL ONLY 5/07/04 RS7 RESDNTL SINGLE FAMILY o Owner Contractor BOTNEN, JENNIFER 628 E 11TH ST PORT ANGELES ( 36) 452-6125 OWNER WA 983627938 Permit Additional desc Permit Fee Issue Date Expiration Date ELECTRICAL NEW RESIDENTIAL 200 A SERVICE 76.30 Plan Check Fee 5/07/04 Valuation 11/03/04 .00 o Qty Unit Charge Per 1.00 76.3000 ECH EL-RM-0-200 1ST SRV FEEDER Extension 76.30 ~ ~. ~\ ~ ~~ ":... ~\ C ~ '-. '- \~ CA "\ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 76.30 76.30 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 76.30 76.30 .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 for a period of 180 days after the work as 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 per . does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the perform e of construction. Signature of Contractor or Authorized Agent Date T:\PLANNING\FORMS\1102.15 [11/14/2003] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING I FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I MECHANICAL HEA T PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'5: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'5 SEPA: PARKING/LIGHTlNG ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 5;7/0 </ A-ee-;J ELECTRICAL LIGHT DEPT . CONSTRUCTION - R.W. CONSTRUCTION R.W. 1 PWI ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\PLANNING\FORMS\1102.15 [11/14/2003J ,ii.,~,..~,,~,', .. ., r.i, ~-' , , OIJYPl" PORT ANGELES " DEPARTMENT OF C()MMUNITY DEVELOPMENT - BUILDING DMSION 321EASTSTaSTREEI,i>ORTANGELES, WA98362 " 50.00 9/12/03 3/11/04 Plan Check Fee Valuai:ion . . .00 o -: -:' ~ Application Number Property Address ASSESSOR ,PARCEL NUMBER: Application description SUbdivisionName . . Property ZOning . . . Application valuation . 03-00000890 Date 9/12/03 628E '11TH ST 06-30-00-0-3-3810:0000- MECHANICAL APPL. PERMIT 2400 OWner Contractor BOTNEN, JENNIFER 628 E 11TH ST PORT ANGELES (360) 452-6125 WA 983627938 EVERWARM 257151 HWY101 PORT ANGELES (360) 452-3366 WA 98362 Permit . . . . Additional desc permit Fee . . Issue Date ExpirationDate. MECHANICAL PERMIT Qty Unit Charge Per 1;00 50.0000 ECH ME-WOOD STOVE Extension 50.00 Fee summary Charged Paid Creaited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 50.00 50.00 .00 .00 Plan Check Total .00. - .00 .00 .00 Grand TO,tal 50.00 50.00 .00 .00 ~ 'f5' ~ 1'1 Date SeparatePermltsar&requlred forel~cal work,SEPA; ~J1orellne;ES~l!tlJjtlel?, private anci publlcirnprov~01~n~. !hls~rmit~coT~S null and yoldlfwork or construction authorized is not contmencedwithin 180 days, if construction orworkjs.sus~nded.or:;'abandoned for, a period of. 180 days after thework,ascomlllenced,orif requh...d Inspe~tlons have not been requestedwithln1~O"daYsfromJ~~ last Inspection. ,r hereby certify that I have read and ,examined this application and know the same to be true'and correct. '.1\n'Pl'Ovisi~ns. ()f laws and ordinances govemlng this type of work will be complied with whether specified herein or not Thegrarrtingof8~tmttd()es (lOt presume.to give authority to violate or cancel the provisions of any state I law regulating Construction or the performance 9f construction,' . , T:\PLANNlNWORMS\ll02.IS [412002] BUILDING'PERMIT INSPECTION RECORD > ". '" __ c. .' ': " _, ",.,_vt@.:},"'{'(~, . _':;;t:,:-,-'::,~:_::'- CALL 417-4815 FOR BUILDING INSPECTIONSJPLEAS:E:PROVIDEAMINIMoM24HOURNOTICE. ITIS UNLAWFUL Tq~~~R, IfIISULATEOR r;ONc:EAL ANY WORK BEFORE INSPECTED AND ACCEPTED. Post PERMITINA CONSPICUOUS LocATiON.~ ..,':,.~ . ,..t -", '~_:: - ,_::'-',~;',~~~-' "~';::':.'~':':::'::4'.;::7~~,~;.; . -;;.~.; KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE ,i' ,;' INSPECTION TYPE DATE' '. ACCEPTED YEs I 'No~,.,L"i" . Co~~ ,'">,,, . '. :1"'!\ ,,< 'v ' I FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ." . ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: 1# ROUGH-IN "', , I ,:' .<. ," , '.' .'" , ( ',: I I PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW I WATER AIR SEAL <' WALLS .~ CEILING FRAMING JOISTS I GIRDERS SHEAR WALL , WALLS I ROOF I CEILING DRYWALL T-BAR INSULATION SLAB WALL I FLOOR I CEILING MECHANICAL HEAT PUMP -C' , . ,,' , ":, , " ; I '.' , , '. . :':' ',;',' . 'c.' ". ,,"", : , -:- I .. , WOOD STOVE I PELLET I CIDMNEY HOOD I DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT II's: WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT I#'s PARKlNGlLIGHTlNG LANDSCAPING , SEPA: BSA: " ",. BLECTRICAJ..tLIGHT DEPT. , ., > SHORELINE: ", ~~M:dN.M.pI~NS~tJ.IREDPRlO'T90f;~~Il!~~-.A;,",., .', "., . DATE YESNO'}~ccJ;U., DATE"", il~~PT~1) ,i,;' .' ':',."<:~",/, "'" ,', y;.tjsc[', ';~O :, . ""i. .,' " ,', """""","'Tf.Fi:C;'~ ,,-,C 1\'" iT'" 4t7-47~5 f~# ~i ""::":>1 """'",.:, . !.i ' RESIDENTIAL CONSTRUCTION R. W.I PWI ENGINEERING FIRE.;.. ........ pLAmlING DEPT. BUILDING, ,,~. __ 417-4807 ',' 4(7r1~53..;~ .... ", 417-47S0,~., " 417-4815 ~~. -'. 1, 'cONSTRucTIoN, R. w;' PW IENGINE1WNG FIRE DEPT. '. ~.: PLANNn.fai>lmfi' ",' ..: .....~-, ". BUILDING " " ': T:\PLANNlNG\FOllMS\tI02.15 [4/2002) r- BUILDING PERMIT - APPLICATION FOR OFFICIAL USE ONLY: Date Rec.: 0/ /ff/f!:J ~ Permit #: gq 0 Date Approved: Date Issued: Fill out COMPLETELY aud iu INK. Your application and site plan MUST BE COMPLETE to be accepted for review. If you bave any questions, call (360) 417-4815 Applicant or Agent: je.,v...v\ftm (j'&-w ~.rV\ev\... Owner: f W\V\lW ~ -SO'"W t?ohttw\. Address: ~~ r; II~ City: rt.c Phone: 4~ -z...- (pI z..? Phone: 4-~-z.. ---(e[ "2.-7 Zip: '1'b'7(P?'-- Phone: State License #: Exp: Phone: 4[z./~?(At7 Zip: ZONING: PROJECT ADDRESS: ~ Z--9J ~ City: ({-fli ~ f.J FA fr./A- qg 3fpz..-- Block: Subdivision: LEGAL DESCRIPTION: Lot: CLALLAM COUNTY PARCEL NUMBER: Credit Card Holder ~ame: J~ g~-fh~ Billing Address: T 0 ~ ~ City: r~ . . :t.1 (J/) COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: No. of Stories: Lot Size: Existing Sq. Ft. & Proposed Sq. Ft. Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage Construction Type: = TOTAL Sq.Ft. % APPROVALS: PLAN: BLDG: DPWU: F1RE: OTHER:_ PLANNING USE ONLY: ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: BUILDING PERMIT APPLICA TION SUBMITTAL: The Building Division can provide you with information on the application and plan submittal requirements if you have questions. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-48 rmit is issued within 180 days of the date ofapplication, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of the Uniform Building Code, current edition). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are require, he City's, and that I must obtain such permits prior to work. T:\FORMS\APPS\Buildingpennit.wpd Applicant: Date: q "';).3 ,L? PREPARED 10/16/03, 12:49:12 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 8 10/16/03 ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 628 E 11TH ST EVERWARM BOTNEN, JENNIFER 06-30-00-0-3-3810-0000- 03-00000890 MECHANICAL APPL. SUBDIV: PHONE (360) 452-3366 PHONE: (360) 452-6125 PERMIT PERMIT: ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ME99 01 ~ -------------------------------------- COMMENTS AND NOTES -------------------------------------- 10/16/03 MECHANICAL FINAL Final free standing wood stove jenifer 452-6125 inspection is for thrus. Oct. 16th ELECTRICAL PERMIT APPLICATION " FOR OFFICIAL USE ONLY Date/ReI;- Pennilfl: Date Approved- Datelssucd The Electrical Permit Application must be filled out comDletelv. / O~ -388 ItNIfl,fiJ 5/.yor' Please type or reprint in ink. tfyou have any questions, please call (360) 417-4735 Fax number: (360) 4174711 Owner or Elee. Contractor Agent ,,~;';), n, ,...." ~~ c."........."-.....-- Phone: Fax: Property Owner; Phone: Address; Ie 2_ tt" e r if f'S e-. .- City: ;'\ Zip: Elecbical Contractor: License #: '}x~ . Exp: Phone: Address: City: Zip: ,- INSTALLATION WIRED BY: DOWNER o ELECTRICAL CONTRACTOR Credit Card Holder Name: Billing Address: City: Zip: Credit Card Number: Exp. Date: VISA:_ Me: 02.5 E -r'L... g!~ PROJECT ADDRESS: TYPE OF WORK: Check all that apply: 0 New o Alteration/Addition o Residential 0 Multi-family o Commercial 0 Mobile Home Sq, FI o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump o Low Voltage 0 Telecom, 0 Sign Number of Circuits added or altered: DESCRIPTION OF THE ELECTRICAL PROJECT: I..-<--'P bt\. 1'\'0 ot_ Tl::J l"..-OD A }J t.ln.~t 3~_ PA-"'l ~L :' Electrical Heat Load Additions and or Subtractions D'lO (,') PrO c."fiA-,,~&t- Service Information o Baseboard o Furnace o Heat Pump o Fan-Wall _KW KW TON KW r LRA o Overhead Service o Temp Service o Underground Service Voltage: Phase: 0 1 0 3 Service Size: Feeder Size: / hereby certify that I have read and examined this application and know that same to be true and correct, and / am authorized to apply for this permit. I understand it is not the City's lega/ responsibility to determine what permits are required; it remains the applicants responsibility to determine what permits are required and to obtain such. Credit Card Holder's Signature: C4,~ / Date: Owner or Elec. Cont. Signature: Date: {9r<"70'/ C:/ELECTRICALPERMITAPPLlCATION PERMIT FEE: $ Application Number . . . . . 22-00001354 Date 10/31/22 Application pin number . . . 724156 Property Address . . . . . . 628 E 11TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-3-3810-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Heat pump system ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BRIAN BELL AND TRACY BEALS DAVE'S HTG & COOLING SRVC INC 628 E 11TH ST PO BOX 413 PORT ANGELES WA 983627938 PORT ANGELES WA 98362 (360) 452-0939 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . . Permit Fee . . . . 56.00 Plan Check Fee . . .00 Issue Date . . . . 10/31/22 Valuation . . . . 0 Expiration Date . . 4/29/23 Qty Unit Charge Per Extension 1.00 56.0000 ECH EL-LVT-THERMOSTAT 56.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 56.00 56.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 56.00 56.00 .00 .00 1 - 2 SINGLE-FAMILY ELECTRICAL PERMIT APPLICATION Public Works and Utilities Department 321 E. 5th Street, Port Angeles, WA 98362 360.417.4735 I www.cityofpa.us I electricalpermits@cityofpa.us Project Address: 628 East 11th Street Project Description: Low voltage thermostat wire for thermostat as part of ducted heat pump installaton tl Single-Family Residential O Duplex/ ARU Building Square footage: _9_5_4 _ -0 (I) 3 ;::;: OWNER INFORMATION Name: Tracy Beals Mailing Address: 628 East 11th Street, Port Angeles, WA 98362 Email: fuschiafern@gmail.com Phone:3607974945 ELECTRICAL CONTRACTOR INFORMATION Name: Dave's Heating & Cooling Service, Inc. Mailing Address: PO Box 413, Port Angeles, WA 98362 Email: davesheating@wavecable.com License: DAVESHC9912C Expiration Date: _5/_2_02_3 _ Phone: 360-452-0939 PROJECT DETAILS I.mm 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 CircuiULimited Energy - 1&2 DU. Manufactured Home Connection Renewable Elec. Energy: 5KVA System or less Thermostat (Note: $5 for each additional) First 1300 Square Feet ~.......t '--"-IQ...- Each Additional 500 square feet" Each Outbuilding / Detached Garage Each Swimming Pool / Hot Tub Voit Charge Quantity $120.00 $146.00 $205.00 $262.00 $373.00 $5.00 $63.00 $5.00 $75.00 $93.00 $110.00 $149.00 $168.00 $96.00 $64.00 $120.00 $102.00 $56.00 ....,1=-_ $120.00 $40.00 $74.00 $110.00 I2lil.( (Quantity x Unit Charge) $ _ $ _ $ _ $ _ $ _ $ _ $ _ $ _ $ _ $ _ $ _ $ _ $ _ $ _ $ _ $ _ $ _ $ 56.00 $ _ $ _ $ _ $ TOTAL $ 6.00 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. 1012s12022 Laci Williams Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator) [Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711] Electrical Information Form Public Works & Utilities Department (360) 417-4700 City Electrical Inspector (360) 417-4735 P ro je c t In fo rm a tio n xisting S ing le -fam ily reside nce C o m m e rci a l D O ve rh e ad se rv ice D U nde rgro un d se rv ice □N e w D M ulti-fam ily reside nce; # o f u nits D S ub divisio n D G e ne ral se rv ice □O the r: Detailed description of work: (Oil to Gas Conversion, Gas to Electric, New Heat Pump, etc.) M a in D is co n n e c t S ize A m p s : ¾: S e le ct V o ltag e : 12 0/24 0 1p h D 12 0/24 0 3ph D 12 0/208 3ph D4so 3 W 3p h D 27 7/48 0 3 ph C h e c k all th a t ap p ly : S u p p o rt in g S tanda rd reside n tia l load s (Li ghting , refr ig e rato r, dish w ashe r, w ashe r) D A/C (_ton) D R ange/O ven D H o t T ub D C lo thes D ry er r½H e ating D P um p s ( __ H p ) D W ater H e ate r D E le va tor (_H p ) D O the r _ L oad Increase (kW ) 0 · S Lo ad D e crea se (kW ) {) P le as e pro v id e a c o p y of th e fo ll o w in g : *D etaile d p lot p la n (.dw g or .dxf fo rm a t m a ndatory fo r subdivisio ns). *E le ctrical one-line d raw ing show ing the se rv ice entrance p ane l and locatio n . *C o nne cted lo ad d ata. *S ize and lo cke d ro tor A pplicant's S ig nature: D ate : lb M A IL O R D E LI V E R C O M P L E T E D F O R M T O : 3 2 1 E 5T H S T R E E T ; P O R T A N G E L E S , W A 98362 F AX T O : 3 6 0-4 17 -4 7 1 1 w s _ W F _ Revised 1-09-11 PREPARED 10/25/22,14:40:22 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:22-00001354 628 E 11TH ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL ALTER RESIDENTIAL 56.00 TOTAL DUE 56.00 Please present reciept to the cashier with full payment ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: Furnace / Heat pump / T-stat NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 11/29/2022 22-1354 TAP OWNER CONTRACTOR Dave’s Heating PROJECT ADDRESS 628 E 11th St Application Number . . . . . 22-00001479 Date 11/29/22 Application pin number . . . 412375 Property Address . . . . . . 628 E 11TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-3-3810-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Furnace / Heat pump ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BRIAN BELL AND TRACY BEALS EXTRA MILE TECH & ELECT., LLC 628 E 11TH ST 418 N. RACE ST. PORT ANGELES WA 983627938 PORT ANGELES WA 98362 (360) 457-5222 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . . Permit Fee . . . . 73.00 Plan Check Fee . . .00 Issue Date . . . . 11/29/22 Valuation . . . . 0 Expiration Date . . 5/28/23 Qty Unit Charge Per Extension 2.00 5.0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 10.00 1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 73.00 73.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 73.00 73.00 .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 PREPARED 11/28/22, 7:27:49 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:22-00001479 628 E 11TH ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL ALTER RESIDENTIAL 73.00 TOTAL DUE 73.00 Please present reciept to the cashier with full payment ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: Furnace / Heat pump NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 11/29/2022 22-1479 TAP OWNER CONTRACTOR Extra Mile Electric PROJECT ADDRESS 628 E 11th St