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ELE C. CAL PERMIT M ( .
CITY OF=PORT ANGELES
360-417-4735
Application Number 16-00000573 Date 4/22/16
Application pin number . . 765282
Property Address 100 1/2 S PEABODY ST SLIGT
ASSESSOR PARCEL NUMBER: R6-30-00-0-0-0000-0000-, REPORT SALES TAX
Application type description ELECTRICAL ONLY on your excise tax form
Subdivision Name
Property Use to the City of Port Angeles
Property Zoning UNKNOWN (Location Code 0502)
Application valuation . . . 0
Application desc •
New service street lights
Owner Contractor
CITY OF PORT ANGELES OWNER
PO BOX 1150
PORT ANGELES WA 983620217
- t Permit ELECTRICAL ALTER COMMERCIAL
Additional desc .
Permit Fee . . 132.00 Plan Check Fee . . .00
Issue Date . . . . 4/22/16 Valuation . . . . 0
Expiration Date . . 10/19/16
Qty UTiit Charge Per Extension
1.00 132.0000 ECH '-EL-COM 0-200 SRV FEEDER 132.00
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 INSpECI1ON
Signature of owner or Electrical Contractor X Date:•
G:\EXCHANGEIBUILDING
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CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street—P.O.Box 1150/Port Angeles Washington,98362 `�11 ` --...1Ph: (360)417-4735 Fax: (360)417-4711
Date: '1.--.2 i—i , Multi-Family or Commercial*
*Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: /On ii. $. "6404,47 -sr—
Building
Square Footage:
Description of above KC44) .SA•Q✓Set, ,'o.� Sitta.A7' La iteirs 1 5r4 I toALr
Owner Information Contractor Information
Name: Gc ir.4 tr A-4, .s Name:
Mailing Address: P. Mailing Address:
City: State: Zip: City: State: Zip:
Phone: Fax: Phone: Fax:
License#1 Exp. License#/Exp.
Item Unit Charge Total(Qty Multiplied by Unit Charge)
Service/Feeder 200 Amp. $132.00 / $ /3Z OiD
Service/Feeder 201-400 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 W/Service Feeder $ 5.00 $
Branch Circuit W/O Service Feeder $ 74.00 $
Each Additional Branch Circuit $ 5.00 $
Branch Circuits 1-4 $ 86.00 $
Temp.Service/Feeder 200 Amp. $102.00 $
Temp.Service/Feeder 201-400 Amp. $121.00 $
Temp.Service/Feeder 401-600 Amp. $164.00 $
Temp.Service/Feeder 601-1000 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
$ /32.f 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
0 Credit Card#
x C Q,. Dated: 4/— 2./ — Up 01/01/2012