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10/08/2019 07:42 FAX 360 452 9265 Angeles Electric Q 0001/0001
1 - 2--SINGLE-FAMILY '
ELECTRICAL PERMIT APPLICATION
Public Works and Utilities Department
321 E. Sth Street, Port Angeles,WA 98362
360.417.4735 t www.cityofpa.us I electricalperrnitsCcityofpa.us
Project Address: ! �'j
Project Description: wfl .S
R';5ngle-Family Residential ❑ Duplex/ARU i3 Una Square footage:
OWNER INFOR IATION
Name: Email:
Mailing Address: r Phone:
ELECTRICAL CONTRACTOR INFORMATION
Name: Angeles Electric, Inc. License:ANGELE1460RS
Mailing Address:524 E. First Street, Port Angeles,WA 98362 Expiration Date:2/1/20
Email:ksimpsoneolymeus.net Phone.360-452-9264
PROJECT DETAILS
1= Knit Charge QuanSily J2W(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 $76.00 $
Temp.Service/Feeder 200 Amp. $93.00 $
Temp.Service/Feeder 201400 Amp. $110.00 $
Temp.Service/Feeder>401-600 Amp.
Temp.Service/Feeder$01-1000 Amp. $1;68:00 $
Portal to Portal Hourly $96:00. $ w
Signal Circuit/Limited Energy-132 DU $fi4 D0 $
Manufactured Home Connection. $1-20.00: $
Renewable Elec.Energy:5KVA System or less'
Thermostat(Note:$5 for each additional). $5t0
TOTAL $
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-
46 The City of Port Angeles Municipal Code,and Utility Specifics ns and P6MC 14.05. regarding Electrical Permit Applications..
Ken Simpson
ate Print Name Signature(❑ Owne Electrical Contractor/Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@dtyofpa.us or faxed to 360.417.4711]
ELECTRICAL INSPECTION
WIRING REPORT
417-4735
DATE: PERMIT 4 INSPECTOR
115-)
OWN
CONTRACTOR
ADDRESS
- 14/�
APPROVED NOT APPROVED
E3 . . . . . . . . . . . . . . . . . . . . DITCH . . . . . . . . . . . . . . . . . . . 13
ROUGH IN/COVER . . . . . . . . . . . . . . . 13
E3. . . . . . . . . . . . . . . . SERVICE. . . . . . . . . . . . . . . . . . 0
0. . . . . . . . . . . . . . . . . . . . . FINAL . . . . . . . . . . . . . . . . . . . . 0
CORRECTIONS NEEDED: WACAS
v rr-tz-
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- 00 NOT REMOVE-