HomeMy WebLinkAbout138 FOREST AVE - Building (3) a
� �CAL PERMIT ='
ANGELES
� - 5
Application Number ' . `19-00000181 Dare 1/30/19
Application pin number' 716792 REPORT STATE SALES.,TAX'.
Property Address . . 138 FOREST AVE Df1 yOU/ GXCISe #eX form
ASSESSOR PARCEL NUMBER: - 06-30-09-5-2-3542-0000-
Application type description ELECTRICAL ONLY to the Ci#y'Of Port AngeleS.
Subdivision Name
Property Use (Loceflon Code 0502)
Property Zoning . . . . . RS7 RESDN'TL SINdLE FAMILY
Application valuation 0
-------------- ------
Application desc
Car charging station
Owner Contractor
----- -------------------
B0981 C FABELLAWO-ST AL
OWNER
138 FORREST`AVE
PORT ANGELES WA :983622516
-------
-------------------------------------------
Permit
-•---------- -------------
Permit ELECTRICAL ALTER RESIDENTTDL.
Additional desc
Permit Fee . . 63.00 Plan Check Fee .00
Issue nate 1/30/19 valuation 0
Expiration Date 7/29/19
Qty. Unit Charge Per Extension /
1.00 63.4000 SQi BL-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 w06. 00
Grand Total 63.00 63.00 .00 .00
INSPECTION TYPE DATE:. RESULTS INSPEMR
DITCH
SERVICE
RM 011-IN
MA
COMMOM:
PERMU WILL E"ME SIX(6)MOMMS S.FROM LAST INSPEMON
Signature of owner Or Etectdcal Contractor X Date:
1 — 2 SINGLE—FAMILY
ELECTRICAL PERMIT APPLICATION RECEIVED
Public Works and Utilities Department
321 E. 5th Street,Port Angeles,WA 98362 JAN 19 1019
360.417.4735 j www.cityofpa.us I electricalpermits@cityofpa.us (�
Project Address: 138 Forrest Ave
Project Description: Install Electric Car Charging station
In Single-Family Residential O Duplex/ARU Building Square footage: —1000
OWNER INFORMATION
Name: a o ngswo Emair. m o ympus.ne
138 ForrestAve -
Mailing Address: Phone:
ELECTRICAL CONTRACTOR
. . .. s
Name: License`
Mailing Address: Expiration Date:
Email: Phone:
PROJECTDETAILS
ISN SSC JQuarif,X Unit Charge)
Service/Feeder 200Amp. $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 1006 Amp. $373.00 $
Branch Circuit W1 Service Feeder $5.00 $ 63.00
Branch Circuit W/O Service Feeder $63.00 �^ $
Each Additional Branch Circuit $5.00 $
Branch Circuits 1.4 $75.00 $
Temp.Service/Feeder 1200 Amp. $93.00 $
Temp.Service/Feedelr 201 Amp. $110.00 $
Temp.Service/Feeder-401-600-Amp.
Temp.Servioe/Feeder 601-1000 Amp. 516$.00
Portal to Portal Hourly $96.00 <$
Signal Circuit/Limited Energy.,U21 i?u. $64.00 $
Manufactured Home Connector $120:00 =$
Renewable Elea Energy:5KV) e�rleas" $102.00 $ "
Thermostat(Note:$5 for each addiNdrwl) $56.40 $
RON
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 Specification and MC 14.05 50 arding lectrical Permit Applications.
?—�O/9 mgA* A/t e,e*
Date N Q.2r)/q Print Name VSign u (ja Owner ❑ lecbical Contra /Administrator)
/14"ek lyelA
[Electrical Permit Applications may be bmitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.47111