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ELECTRICAL PERMIT
CITY OF PORT ANGELES
366417-4735 .fsS
Application Number 17-00000042 Date 1/13/17
Application pin number . . 387174
Property Address 3518 GALAXY PL REPORT STATE SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-15-7-5-0030-0000- 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 RS9 RESDNTL SINGLE FAMILY
Application valuation . . . • 0
Application desc
Ductless heat pump
Owner Contractor
SCOTT AND JENNIFER MICHAELIS BLACK DIAMOND ELECTRICAL CONTR
3518 GALAXY PL 502 BLACK DIAMOND RD
PORT ANGELES WA 983623751 PORT ANGELES WA 98363
(360) 452-5984 (360) 565-1035
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc .
Permit Fee . . . 63.00 Plan Check Fee . . .00
Issue Date . . . 1/13/17 Valuation . . . . 0
Expiration Date . 7/12/17
Qty Unit Charge Per Extension
1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED - 63.00
Fee summary Charged Paid Credited Due
Permit Fee Total 63.00 63.00 .00 . .00
Plan Check Total .00 .00 .00 .00
Grand Total 63.00 63.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
• DITCH
SERVICE
ROUGH-IN {/3b)j-7 i
FINAL 56/17
COMMENTS: 1
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
•
Signature of owner or Electrical Contractor X Date:
y
0¶'ORT 1rtr.
CITY OF PORT ANGELES PERMIT APPLICATION = _ Pto'..410, -
AWN t
Building Division/Electrical Inspections 0
321 East Fifth Street— Port Angeles Washington,98362 ‘.44,,, r ';1 ..: r
Ph: (360)417-4735 Fax: (360)417-4711 (\3
Date: /-/Q -(7 X&2 Single Family Dwelling 'S SPE(.:'!Oki-
*
ski-*Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 35-(s (•4G. e7 fi 4 i
Building Square Footage:
Description of above
ff
Owner Information Contractor Ir proration
Name: /'h/Gmt-rill Name: 4
Mailing Address: Mailing Address:
City: State: Zip: City: State: Zip:
Phone:9 O-/68J Fax: Phone: EgorcF c:
License#1 Exp. License#/Exp.
Item Unit ChargeQ�(t 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 Feed $ 5.00 $�
Branch Circuit W/O Service Feeder $ 63.00 $
Each Additional Branch Circuit $ 5.00 $
Branch Circuits 1-4 Only $ 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,an. .lity pecifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Signature of ow , •lec •.ntractor or electrical administrator: 0 Cash XCheck
0 Credit Card#
X i� `i Dated: /a—/7 02/06/2012
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