HomeMy WebLinkAbout621 S PINE ST - Building (2)ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number . . . . . 18-00000292 Date 3/07/18
Application pin number . . . 378780
Property Address . . . . . . 621 S PINE ST
ASSESSOR PARCEL NUMBER: 06 -30 -00 -0 -1 -6225 -0000 -
Application type description ELECTRICAL_ ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
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Application desc
Ductless heat pump
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Owner Contractor
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RONALD E DOEBBLER FAMILY TRUST BLACK DIAMOND ELECTRICAL CONTR
5104 OLD SAN ANTONIO RD 502 BLACK DIAMOND RD
FREDERICKSBURG TX 786246128 PORT ANGELES WA 98363
(360) 565-1035
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Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 63.00 Plan Check Fee .00
Issue Date . . . . 3/07/18 Valuation 0
Expiration Date . . 9/03/18
Qty Unit Charge Per Extension
1.00 63.0000 ECH EL -R- BRANCH CIR WO/ SER FEED 63.00
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Fee summary Charged Paid Credited Due
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Permit Fee _Total 63.00 63.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 63.00 63.00 .00 .00-
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REPORT STATE SALES TAX
on your excise tax form
to the City of Pori Angeles
(Location Code 0502)
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INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
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FINAL
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COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X
Date:
Project Address:
Project Description
1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION 3
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 1 www.cityofpa.us I electricalpermits@cityofpa.us
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Single -Family Residential ❑ Duplex /ARU Building Square footage:
Name:-L>OkJ55 Lk-44--
Mailing
(c /LMailing Address: 62l v. '4>I Ill
Name: X1b C
Mailing Address:��
Email:
item
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 Circuit/Limited Energy -1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
tt� bow
Unit Charae
$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
02%00 ;
X74:
Email:
Quantity
TOTAL
Phone: >� /d / X03
License: ,,0r&WAcEL89YV L
Expiration Date:
Phone: X60 '16l--S9S7
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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 electric s, N.E.C., RCW Chapter 19.28, WAC. Chapter 296-
466, The City of Port Angeles Municipal Code, and Utility Specificat' 14.05.050 regarding Electrical Permit Applications.
Date Print Name na a Owner ❑ Electrical Contractor /Administrator)
[Electrical Permit Applications maybe submitted to City Hall or ellie'ttricalpermits@cityofpa.us or faxed to 360.417.4711]