HomeMy WebLinkAbout1020 W 14TH ST - Building (2);K:
LE "m-CAL PERMIT
1�4 6RT— ANGELES
3617-4735
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Application Number 19-00001175 Date 8/07/19
Application pin number ssz000REPORT STATE SALES TAX
Property Address 1020 W 14TH ST OLN'E3XCl$G'tax form ASSESSOR PARCEL NUMBER: 06-30-60-0-4-1315-0000- 0i7 y
Application type description.: ELECTRICAL ONLY to the City Of Port AngeleS
Subdivision Name
Property Use (Location Code 0502)
Property Zoning ., . . . . _. RS7 RESMM SINGLE FAMILY
Applications valuation . . . 0
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Application desc
Service repair
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Owner Contractor
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LEAH J BRB SIMPSON ELECTRIC
839 W;6TH ST 243016 W iWY 101
PORT ANGELES WA 98363- PORT ANGELES WA 98363
(360) 457-9270
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Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc .
Permit Fee 120.00 Plan Check Fee 00
Issue 3ktte . . . . 8/07{19 Valuation . . . 0
Expiration Date 2/03{20
Oty Unit Charge Per - Extension
1.0,0 120.0000 BCH EL-0-200 SRV FEEDER 120.00
.0.0 63.0000 BCH BL-R--,BRANCH CIR WO/ SBR FEED .00
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Fee summary Charged Paid, Credited Due
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Permt Fee Total 120.00 120".00 00 00
Plan-Check Total .00 00 .00 .00
Grand Total 120.00 120.00 00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
P100011=II+T
FINAL
COWENTS:
PERMIT WILL Ej(P SIX(6)MONTHS FROM LAST IN9PWMN
Signature of owner or Electrical Contractor X Date:
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1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION
Public Forks and Utilities Departmental/, 2019
321 E. 5th Street, Port Angeles, WA 98362
1
360.417.4735 1 wwv<.cityofpa.us I electrical perm its cityofpa.us
1020 W 14th St Port Angeles, WA 98363
Project Address: 9 \�
Project Description: Damaged mast \
Single-Family Residential O Duplex/ARU Building Square footage:
OWNER INFORMATION
Name: Lea Erb Email:
Mailing Address: 1020 W 14th St Phone:
ELECTRICAL CONTRACTOR INFORMATION
Name: Simpson Electric LLC License- SIMPSEL973RQ
Mailing Address: P.O. Box 1086 Port Angeles,WA 98362 Expiration Date: 12/11/2019
Email Phone:
PROJECT DETAILS
jtgm Unit Charge Quantity I(Ad(Quantity x Unit Charge)
Service/Feeder 200 Amp. $120.00 1 $ 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 Feeder $5.00 $
Branch Circuit W/O Service Feeder $63.00 $
Each Additional Branch Circuit $5.00 $
Branch Circuits 1-4 $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 DU. $64.00 $
Manufactured Home Connection $120.00 $
Renewable Elec. Energy: 5KVA System or less $102.00 $
Thermostat(Note: $5 for each additional) $56.U0 $
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TOTAL s 120.00
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.
8/06/2019 Andrew P Simpson 4Nq al� /0
Date Print Name Signature(❑ Owner V Electrical Contr ctor/Administrator)
[Electrical Permit Applications may be submitted to City Hall or electrical permits@cityofpa.us or faxed to 360.417.4711]