HomeMy WebLinkAbout918 ST - Building 4
- - N
TICAL PERMIT
CITY O P0 'ANGELES
360-417-4735
Application Number . . 21-00000586 Date 5/18/21
Application pin number . . . 326194
Property Address . . . . . 918 MADELINE ST
ASSESSOR PARCEL NUMBER: 06-30-01-7-6-0210-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . .
Property Use . . . . . .
Property Zoning . . . . . . RS9 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
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Application desc
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Owner Contractor
PARKTERO LLC UPPER LEFT ELECTRIC LLC
105.BENSON CREST 1306 ROOK DR
PORT ANGELES- WA 98363 PORT ANGELES WA 98362
(360) 461`-7720 (360) 461-7.720
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Permit . . . . . ELECTRICAL TEMPORARY SERVICE
Additional-desc
Permit Fee 93.00 Plan Check Fee .00
Issue Date- 5/18/21 Valuation 0
Expiration Date 11/14/21
Qty Unit Charge Per Extension
1.00 93.0000 ECH EL-TEMP SRV 0-200 SRV FDR 93.00
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Fee summary Charged Paid Credited Due
-Permit Fee Total 93.00 93.00 .00 .00
Plan Check Total .00 .00 00 .00
Grand Total 93.00 93.00 .00 .00
REPORT SALES TAX
on your excise tax form
to the City of Pat Angeles
(Location Code 0502)
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE t
ROUGH-IN
FINALS
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST fNSPJN
Signature of owner or Electrical Contractor X Date:
GAEXCHANGEWILDING
1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION 3
Public Works and Utilities Department iv
321 >a. 5th Street, Port.Angeles, W,A 98362 �
360.417,4735 ( www.cityofpa.us j clectricalperinits,iz)cityofpa.us (A
Project Address: 9 madeline
Project Description:temp service
❑ Single-Family Residential ❑ Duplex/ARU Building Square footage:
OWNER INFORMATION
Name: Email:
Mailing Address: Phone:
ELECTRICAL CONTRACTOR ! ' •
Name: upper left electric Licenser
Mailing Address: Expiration Date:
Email: upperleftelectric@gmial.com Phone:
i
PROJECT
&M Unit Charge Quantity TQtai(Quantity x Unit Charge)
Service/Feeder 200 Amp. $120.00 $ 120
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: 5KVASystem or less $102.00 $
Thermostat(Note: $5 for each additional) $56.00 $
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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-
46B,The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
5/16/21 chace botero
Date Print Name Signature(❑ Owner ❑ Electrical Contractor/Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]