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ELECTRICAL PERMIT 1
CITY OF PORT ANGELES
360-417-4735
Application Number 16-00000919 Date £/22/16
Application pin number . . 402345
Property Address . . . 503 LOPEZ AVE REPORT SALES TAX
SESSOR PARCEL NUMBER: 06-30-10-5-0-1609-0000-
1 ,334cation type description ' ELECTRICAL ONLY on your excise tax form
' • Name to the City of Port Angeles
Properti0001
Property Zbf1 9 . RS7 RESDNTL SINGLE FAMILY (Location Code 0502)
Application valuation . . . 0
Application desc -
Addition •
Owner Contractor
UNDERWOOD, JON JEDI ELECTRIC
221 N. JONES ST. 29 W 10TH STREET
PORT ANGELES, WA. ANGELES WA 98363 •
PORT ANGELES WA 98362 (360r.417-9579
•
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc .
•
Permit Fee . . . . 73.00 Plan CheckFee . . .00
Issue Date . . . . 6/22/16 Valuation 0
Expiration Date . . 12/19/16
- I
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
•
Pee 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
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•
•
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4-41
INSPECTION TYPE DATE: RESULTS: . INSPECTOR:
DITCH •
•
SERVICE
ROUGH-IN / 0
013i4 4
FINAL //J
COMMENTS: _ fl4A41/14IP
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
GAEXCHANGEIBUILDING
1
CITY OF PORT ANGELES PERMIT APPLICATION
/..._"11,146,
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Building Division/Electrical Inspections L �____„_s
321 East Fifth Street–P.O.Box 1150/Port Angeles Washington,98362 —
Ph: (360)417-4735 Fax: (360)417-4711 ` IIIIIIIIV
Date: G–D)– I to _1 &2 Single Family Dwelling
*Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 5.6 .. L C1 p G 2
Building Square Footage: 3 (A C3
Description of above
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Owner Information Contractor Information
Name: ' -'0,t. U Aa9! W CO c Name: -3-t a: ILL 4-1 :-
Mailing
'Mailing Address: S a 3 p..t%Pc.-L Mailing Address:
City: al A State: y.l A Zip: City: State: Zip:
Phone: Fax: Phone: Fax: Ay 5--7 C1 q 1 1 1 -7
License#/Exp. License#1 Exp.
Item Unit Charge cu 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 $ OZ---
Branch Circuit W/O Service Feeder $ 63.00 —1— $
Each Additional Branch Circuit $ 5.00 'f— $ / d if
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 $
$ -73 0° 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: 0 Cash 0 Check
ill'Credit Card# 0A. ...1 'e.,_
X & CCUL0 Dated: yal�‘ 0110112012