HomeMy WebLinkAbout1203 CAMPBELL AVE - Building (2) s.
I: C `RICAL PERMIT
CITY PORT ANGELES
X17-4735
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Application Number . 19-00001315 Date 8/27/19
Application pin number . . 498675 REPORT STATE SALES TAX
Property Address . . . . 1203 CAMPBELL AVE
ASSESSOR PARCEL NUMBER: 06-30-14-5-3-0340-0000- on your excise tax form
Application type description ELECTRICAL ONLY to the City of Port Angeles
Subdivision Name. . . . .
Property Use (Location Cod@ 050R)
Property Zoning . . . . 'RESIDENTIAL HIGH DENSITY
Application valuation 0
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Application desc
Temp service
Owner Contraoto
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DON NIVENS : UPPER-
ELECTRIC LLC
PO BOX 212 1306 ROOK DR
SEQUIM WA 98382 PORT ANGELES WA 98362
(360) 961-7720
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Permit ELECTRICAL TEMPORARY SERVICE ----- -
Additional desc
Permit Fee 93.00 Plan Check Fee 00
Issue Date 8/27/19- valuation . . 0
Expiration Date 2/23/20 '
Qty Unit Charge Per . Extension
1.00 93,4400 ECH EL-TEMP SRV 0-20.0 SRV PDR 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 .00 .00
Grand Total 93.00 93.00 00 .00
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Signature of owner or Electrical Contractor X Date:
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1 - 2 SINGLE-FAMILY
• ELECTRICAL PERMIT APPLICATION
Public Works and Utilities Department %.71Q
321 E. 5th Street, Port Angeles, WA 98362 1
360.417.4735 w-ww.cityofpa.us electricalpermits@,cityofpa.us
Project Address: 7 C7_� X-1,:1► (2,
Project Description: Q 0- �-�-
❑ Single-Family Residential ❑ Duplex/ARU Building Square footage:
OWNER INFORMATION
Name: Email:
Mailing Address: Phone:
ELECTRICAL CONTRACTOR INFORMATION
Name: License:
It I Mailing Address: t =�5 Expiration Date:
Email e eAe_kr Phone:
PROJECT
Item Unit Charae Quantity Total(Quantity x 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 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 $ . CGG7-
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) $56.00 $
First 1300 Square Feet $120.00 $
Each Additional 500 square feet" $40.00 $
Each Outbuilding/Detached Garage $74.00 $
Each Swimming Pool/Hot Tub $110.00 $
TOTAL $`7
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.
gO
ate Print Name Si re( ner I Contractor/Administrator)
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417.4711]