HomeMy WebLinkAbout520 GEORGIANA ST - Building ELECI,=,,,-- AL,PERMIT
CrIY Of PORT ANGELES
360-417-4735
'Application Number . . . . . 17-00001207 ' Date 11/22/17 q
Application pin number . . . 928743
Property Address . . . . . . 520 GBORGIANA.'BT REPORT STATE SALE.1 TAX
ASSESSOR PARCEL NUMBER: 06-30-00-5-1-4120-0000-
Application type description ELECTRICAL ONLY on your excise tax form
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
Security System
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Owner Contractor
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DANIEL M BLOOD PROTECT YOUR HOME
1137 W STH STREE T 3750 PRIORITY WAY SOUTH DRIVE
PORT ANGELES #200
PORT ANGELES WA 98363 INDINAPOLIS IN 46240
(317) 810-4720
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Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit Fee . . . . 64.00 Plan Check Fee .00
Issue Date . . . . 11/22/17 valuation . . . . 0
Expiration Date 5/21/18
Qty Unit Charge Per Extension
1.00 64.0000 BCH EL-SINGLE CIR LIMITED RES 64.00
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Fee summary Charged Paid Credited Due
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Permit Fee Total 64.00 64.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 64.00 64.00 .00 .00
rNSPECTION TYPE DATE, RESULTS: INSPECTOK-
DITCH
SERVICE
ROUGH-IN
FINAL
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street—P.O. Box 1150/Port Angeles Washington,9062
Ph: (360)4174735 Fax: (360)417-4711
Date: 1/5/2015 1 &2 Single Family Dwelling
Plan Review May Be Required,Please Complete Electrical Plan Review Information Sheet
JobAddress: 520GeorgianaSt
Building Square Foollagie� 1776
Description of above
Owner Information Contractor Information
Name DanielBlood Name- Protect Your Horre
Ma"AddreSS: 520Georgianast Ma"AddrM: 3750 Priority Way South Dr
city Port Angeles State: WA Zip: 983623322 Ck, Indianapok Slate. IN ZV'46240
Phone: 3606835007 Fax- Ph" 866-502-3559 Fax: 317-564-2547
License#I Exp. Lcense EXp,PROTEYH934RS exp 12/10/2013
Item Unit Charge 91f Total(Qtv Multiplied by Unit Charne)
ServiceiiFeeder 200 Amp. $120.00 $
ServioeYFeeder 201400 Amp. $146.00 $
ServicefFeeder 401-W Amp $205-00 $—
ServiceFeeder 601-1000 Amp. $262.00 $-
Service/Feeder over 1000 Aim. $373.00 $
Branch Circuit W1 Service Feeder S 510 $-
Branch Circuit WO Service Feeder S 6300 $-
Each Additional Branch Circuit $ 5.00 S
Branch Citaits 1-4 $ 7500 $-
Temp.Servicel Feeder 200 Amp, S 93.00 $-
Temp.Service/Feeder 201400 Amp. $110.00 $-
Temp.Service/Feeder 401-600 Amp. $149.00 S-
Temp.Service/Feedet 601-1000 Amp $168.00 S-
Portal to Portal Hourly $ 96.00 S
Si�gnal CirouiV Limited Energy-1&2 Family Dwelling $ 64.00 S 64.00
Manufactured Home Connection $120.00 S-
Renewable Electrical Energy-5KVA System or Less $102.00 S-
Thermostat $ 56.00 $
Note:$5.00 lor each additional T-Slal
NEW C0NSTRUCTIQN_Q&Y,
First 1300 Square Fl, $120.00 $-
Each Adftonal 500 Square Ft.or Portion ot S 40.00 $
Each OutbtAdiing or Detached Garage S 74DO S-
Each Swimming Pool or Hot Tub S1110.00 $
$ 64- Total
Owner as defined by RCW.19.28-2611�(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 ficensed electrical contractor I am making
the electrical installation or alteration in Compliance with the electrical laws,N.E.C.,RCK Chapter 19.28,WAC.Chapter 29646B,The Oty 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 11 Check
55 Cr*M Card 8 1
X '4e�A-Wda& Dated: __1/5/2015 01101012