HomeMy WebLinkAbout3804 FAIRMOUNT AVE - BuildingELECTRICAL RICAL PERMIT
CITY OF PORT ANGELES
3604174735
Application Number . . . . . 18-00001263 Date 8/13/18
Application pin number . . . 133916
Property Address . . . . . . 3804 FAIRMOUNT AVE
ASSESSOR PARCEL NUMBER: 06 -30 -08 -5 -8 -0350 -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
------------------------
HAZZELLE D HOUT
------------------------
BLACK DIAMOND ELECTRICAL CONTR
3804 FAIRMONT AVE
502 BLACK DIAMOND RD
PORT ANGELES
WA 983638325
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 . . .
. 8/13/18
valuation . . .
0
Expiration Date
2/09/19
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
-----------------
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
DITCH
SERVICE '
ROUGH -IN
FINAL
COMMENTS-,
DATE: RESULTS:
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
lt&T 3
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
Project Address:
1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 www.cityofpa.us electricalpermits@cityofpa.us
3$ o y r-941kvha)N T AVC
Pro'ect Description: b %J C-7Vr,15
Single -Family Residential O Duplex / ARU Building Square footage:
OWNER INFORMATION
Name: -aV'r Email:
Mailing Address: 3 904 F,4(1 Phone
Name:
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)
First 1300 Square Feet
Each Additional 500 square feet'
Each Outbuilding / Detached Garage
Each Swimming Pool / Hot Tub
Wot — YV3r
License: Git-Gl�C-gg�f�0 L
Expiration Date:
Phone: e/G I-
Unit Charae Quantity
Total (Quantity x Unit Charge)
$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
$
$120.00
$
$40.00
$
$74.00
$
$110.00 $ t�—
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 t electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-
46B, The City of Port Angeles nicipa� Code, and Utility ci ns and PAMC 14.05.050 regarding Electrical Permit Applications.
Date Print Name �/' /signature (Owner ❑ Electrical Contractor / Administrator)
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417.4711]
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