HomeMy WebLinkAbout3004 REGENT ST - Building CITY OF PORT ANGELES
360-417--4735
Application Number . . . . . 19-00001344 Date 9/03/19
Application pin number 897152 REPORT S TATE SALES TAX
Property Address . . . . . . 3004 REGENT -ST on your excise tax form
ASSESSOR PARCEL NUMBER: 06-36-15-5-6-0400-0000-
Application type description ELECTRICAL ONLY to the City of Port Angeles-
Subdivision Name . . . . .
Prqp�erty Use . . . . (Locatfon Code 0502)
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . .
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Application desc
Bathroom / Kitchenette
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Owner Contractor
------------------------ ----------W-------------- -
FRANCIS & ALICIA BAREVICH SIMPSON ELECTRIC
3004 S RZGENT ST 243034 W HWY 101
PORT ANGELES WA 98362694,9� PORT ANGELES WA 98363
(206) 714-6695 457-9270
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Permit . . . . . . ..ELECTRICAL ALTER RESIDENTIAL
Additional desc 1-4 CIRCUITS
Permit Fee . . . . - 75.00 Plan Check Fee .00
Issue-Date . . . . Valuation . . . . 0
Expiration Date 3/01/20
Oty Unit Charge Per Extension
BASE FEE 75.00
----------------------------------1 .1------ ----------------------------------
Fee-,summary Charged Paid Credited Due
----------------- ---------- ------ --- ---------- ----------
Permit�-Fee Total 7S.'00 75-00 .00 .00.-
Plan Check Total .00 .00 .00 .00
Grand Total 75.00 75.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
CONffVffiNTS:
&W 150 W*"E: JA�T)fjj�=
PERmrr WiLL owmE Svc(6jmwms FROM UST.wspwrm
Signature of owner or Electrical Contractor X Date:
1 - 2 SINGLE-FAMILY (D
1, 3
ELECTRICAL PERMIT APPLICATION
Public NN"orks and Utilities Department
-eet, Port Anc�eles. W-� 98 162
321 F. �th Sti
360.417.4735 1 WW1X.CitV0fPaJ1S electi-icalperi-nits(ii)clt\lloff)a.i.is
Project Address: 3004 South Regent _rZ
Project Description: Bathroom & Kitchenette move Switches and outlets adding 2 outlets
n Single-Family Residential 0 Duplex/ARU Building Square footage:
Name: Alisha Barevich Email:
Mailing Address: 3004 South Regent Phone:206-714-6695
ELECTRICAL CONTRACTOR INFORMATION
Name: Simpson Electric LLC License: SIMPSEL973RQ
Mailing Address: P.O. Box 1086 Port Angeles, WA Expiration Date: 12/11/2019
Email: dlsimpson5l @gmail.com Phone:360-457-9270
PROJECT DETAILS
Unit ChaEge Quante]X JQW(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 14 $75.00 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) $56.00 $
77'
4
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A
fU444"O "n-4i
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Each
TOTAL $ 75.00
Owner as defined by RCW.19.28.261: (1)Ownerwill 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 Code, and Utility Specifications and PAMC 14,05.050 regarding Electrical Permit Applications.
8/30/2019 Andrew P Simpson /a
Date Print Name Signature(E] OwnerV Electrical Contrdctor/Administrator)
[Electrical Permit Applications maybe submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]