HomeMy WebLinkAbout730 W 4TH ST - Building (2) _4,
ELEC' ICAL PERMIT
CITY OF PoRT ANGELES
366.4174735
Application Number . . . 17-00001801 Date 12/07/17
Application pin number . . . 552429
Property Address" . . . . 730 W 4TH ST REPORT STATE SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-99253-0000- On' otlP excise tax form
Application type description ELECTRICAL ONLY y
Subdivision Name . . . to the City of Port Angeles
Property Use . . . .
Property Zoning. . RS7 RESDNTL SINGLE FAMILY (Location Code 0502)
Application valuation . . . . 0.
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Application desc
Furnace
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Owner Contractor
DEREK G AND JACQUELINE M MEDIN BLACK DIAMOND ELECTRICAL CONTR
730 W 4TH ST 502 BLACK DIAMOND RD
PORT ANGELES WA 983632246 PORT,ANGELES WA 98363
(360) 565-1035
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Permit . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc 1-4 CIRCUITS
Permit Fee 75.00 Pian Check Fee .00
Issue Date . . 12/07/17 valuation . . . 0
Expiration Date 6/05/18
Qty Unit Charge Per Extension
BASE FEE 75.00 j
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Fee summary Charged Paid Credited Due
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Permit Fee Total 75.00 75.00< .00 .00
Plan Check Total .00 .00 .00 .00
Grund Total 75.00 75.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
CON04ENTS: AA1 7. -ZO
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
CITY OF PORT ANGELES PERTNUT APPLICATION j �►�,.�•
Building Division/Electrical Inspections )
321 East Fifth Street— Port Angeles Washington,98362 „ J
Ph: (360)417-4735 Fax: (360)417-4711
Date: (7 1 &2 Single Family Dwelling
*Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 730 W ti-m
Building Square Footage:
Description of above
64-LAZE "-,p 2 f
Owner Information Contractor Ind��ion
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Name: AN( Lj2s f-1-T Name: r,
Mailing Address: Mailing Address:
City: State: Zip: City: State' Zip:
Phone: ' Fax: Phone: Fax:
License#I Exp. License#/Exp.���{
Item Unit Charge Qty 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 Feed $ 5.00 $
Branch Circuit W/O Service Feeder $ 63.00 $
Each Additional Branch Circuit $ 5.00 $
Branch Circuits 1-4 Only $ 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 $
$ al
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 Co e,and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit A plications.
Signature owne el rical contractor or electrical administrator: ❑ Cash�' Check
y ❑ credit caro#
x Dated: ��—/� / / 0210612012
Val�__ 6
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