HomeMy WebLinkAbout123 W 4TR ST - Building <S ., CAL pE2MIT'
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Application Number19-00000900 Date 6/13/19
Application pin number . . 287800 REPORT STATE SALES TAX
Property Address . . . 123 W 4TH ST'
ASSESSOR PARCEL'NEER: 06-30-OO-Q-0-7060-0000- on your'@XC►S6t`tax lbrm
Application type description ELECTRICAL ONLY
to the City Of Port Angeles
Subdivision.,Name
Property Use (Locadon Code 0502)
: .
Property ZoningRESIDENTIAL HIGH DENSITY
Application valuation . . . 0
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Application desc
Temp:Service '.
Owner Contractor
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Cathy LaBelle SIMPSON ELECTRIC
123 W 4TH ST 243036 W HWY 101
PORT ANGELES WA 983622805 PORT ANGELES WA 98363
(253) 686-0505 (360) 457-9270
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7*
Permit
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Permit . . ELECTRICAL TEMPORARY SERVICE
Additional des-c
Permit Fee 93.00 Plan Check Fea .00
Issue Date` . 6/13/19 Valuation 6
Expiration Date .. 12/10%19
Qty Unit Charge Per Extension
1.00 93.0000,BCH EL-TEMP SRV-0-206 SRV'FDR 93.00
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Fee summary Charged Paid Credited Due
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Permit Fee Total 93.00 93.00 .00 .00
Plan Check Total 00 .00 Ofl 00
Grand Total 91.00 93.40 00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINALAM
COMMENTS'
PERMrr WILL Emu SIX(6)MONTHS FROM t.AsT E3SPEC m
Signature of owner or Electrical Contractor Date:
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ELECTRICAL PERMIT APPLICATION REtErv-t
Public Works and [utilities Department
321 T. 5th Street, Part Angeles, Nk,;a 98362
360.417.4735 1 AtwAv .cityofpa.us 1 clectricalpermits(iz�,cityofpa.us
Project Address: 123 W 4th St Port Angeles
Project Description: Temp Service
❑ Single-Family Residential ❑ Duplex/ARU Building Square footage:
Name: Cathy Labelle Email:
Mailing Address: Phone 1-253-686-0505
ELECTRICAL CONTRACTOR • ' i
Name: Simpson Electric LLC License:SIMPSEL973RQ
Mailing Address: P.O. Box 1086 Port Angeles, WA 98362 Expiration Date: 12/11/2019
Email: disimpson5l@gmail.com Phone: 360-457-9270
PROJECT DETAILS
Jtgpl Unit,-Charge Quantity JQW(Quantity x Unit Charge)
Service/Feeder 200 Amp. $120.00 $'
Service/Feeder 201-400 Amp. $146.00 T $
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 Feeder $5.00 $
Branch Circuit W/0 Service Feeder $63.00 $
Each Additional Branch Circuit $5.00 $
Branch Circuits 1-4 $75.00 $
Temp. Service/Feeder 200 Amp. $93.00 1 $ 93.00
Temp. Service/Feeder 201-400 Amp. $110.00 $
Temp. Service/Feeder 401-600 Amp. $149.00 $
Temp. Service/Feeder601-1000 Amp. $16$,00 $
Portal to Portal Hourly $96.00 $
Signal Circuit/Limited Energy-1&2 DU. $64.00 $
Manufactured Home Connection $120.00 $
Renewable Elec. Energy: 5KVA System or less $102.00 $
Thermostat(Note: $5 for each additional) $56;00 $
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TOTAL $ 93.00
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-
468,The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
6/11/2019 Andrew P Simpson 44a4z6lo-100
Date Print Name Signature(E] Owner V Electrical Contractor/Administrator)
[Electrical Permit Applications maybe submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]