HomeMy WebLinkAbout1128 ST - Building EIAOMOAL PERMIT"
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Application Number . 19-00001483 Date 9/24/19 `
Application Pin number . . 521120 REPORT STATE SALES TAX
Property Address . . . . 1128 R 3RD ST on your excise tax fmm
ASSESSOR PARCEL NUMBER: 06-30-00-7-9-0310-0000-
Application type description ELECTRICAL ONLY to the City Of Pcxt Angeles
Subdivision Name . . . .
Property Use . . . . . (Location Code 0542)
Property Zoning . . RS7 RSSDNTL SINGLE FAMILY
Application valuation 0
Application desc
DHP
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Owner Contractor
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JUSTIN S / RICHELLE M KIMBLE BLACK DIAMOND ELECTRICAL CONTR
1128 E 3RD ST 502 BLACK DIANORD RD
PORT ANGELES WA 90362 PORT ANGELES. WA 98363
(360) 808-8441 (360) 565-1035
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Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc .
Permit Fee 63.00 Plan Check Fee . .00
Issue Date 9/24/19 Valuation . p
Expiration Date . 3/22/20
oty Unit Charge Per Extension
1.00 63.0000 RCB' EL-R- BRANCH CIR WO/ SER FRED' 63.00
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Fee summary Charged Paid Credited Due'
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Permit Fee Total 63.-00 63.00 .00 .00
Plan Check Total` .'00 .00 .00 .p0
Grand Total 63.00 63..00 00 .00
INSPECTION TYPE DATE: RESULTS: WSPECTOR:
DITCH
SERVICE
ROUGH_.
FINAL
CON04E M:
PERMrr'W,U .EXPIRE SIX(6)MONTHS FROM L.AS'K 1i'I'St'R010N
Date:ipawm of owner or Electrical Contmctar X
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2 SINGLE-FAMILY
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3
ELECTRICAL PERMIT APPLICATION
.
Public Works and Utilities
Department
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32| G. jdhStreet, Port Angeles, VVA90362 °
360.417,4735 | w-wmcityofpa.us i electrical perm ituCaoityofpa.uy
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Project Address: , »7-8
Project Description: r,>U�~"
[] Singb+Fomi|yRmadenda| [] Duplex/ARU Building Square footage:
OWNER INFORMATION
Name: Email:
Mailing Address: Phone: FOR- C.ri L41
ELECTRICAL CONTRACTOR INFORMATION
Name: License:
Mailing Address: Expiration Date:
Email: Phone:
PROJECT DETAILS
item Unit Charge Quantity !QILI(Quantity x Unit Charge)
Service/Feeder 20VAmp. $120.00 *-________
Service/Feeder 2O14OVAmp. *146.00 $__________
Service/Feeder 4O1-8nOAmp. $205.00 $-_________
Service/Feeder G0t-1O0OAmp. $262.00 $_________
Service/Feeder over 10OOAmp. $373.00 __---_ $
Branch Circuit wW Service Feeder $5.00
Branch Q�uitV�OGomivaFeeder *63.00
EochA�didono|BnonohQ�ui� $5�OD
Branch Circuits 1'4 $75.00 $-___----__
Temp.Service/Feeder 2OOAmp. $93.00 $-____---__
Temp.Service/Feeder 2O14DOAmp, $110.00 $_-_________
Temp. Service/Feeder 4O1'G0UAmp. o149.00 $-____--___
Temp.Service/Feeder 001'10UnAmp. $188.00 $-_____-__
Portal oo Portal Hourly $90.00 __---_ $____-----_
Signal Circuit/Limited Energy'1&2DU, $84.00 $-____---__
Manufactured Home Connection $120.00 *____-____
Renewable ElecEnen0y:5KVA System orless s102.00 $-_____--__
Thermostat(Note:$5 for each additional) m56.00 $-___---__-
First 13O0 Square Feet $120.00 $-_____-__
Each Additional 5OV square feet" $40.00 *
Each Outbuilding/Detached Garage $74.00 $__________
Each Swimming Pool/Hot Tub $110.00 $
TOTAL $
Owner ao defined byRCW.19.28161:(1)Owner vAll 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, E RCVK Chapter 28 VUAC Chapter 296'
46B,The City of Port ngeles Municipal Code, and Utility S cifi ns and PAMC 14.05.050 regarding Electrical Permit Applications.
Date Print Name '/Slk;nature A Owner F1 Electrical Contractor/Administrator)
(Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa,us or faxed to 360.417.4711]