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pplicaticttt Number a -000005laDaWEPMJPSTATE SALES TAX
application pinnumber 64 888
Arty Address 1714 � 11TH sT Ol7 your excise tax forr►1
ASONSSORPARCEL aroMU: 0 -30-00--0- -06�,0-ooao- to the City of Port Angeles
Application type description ELSCT�fICn ONLY
Subdivision Fame : . . (Locadon Cade 0502)
Property Use . . . , .' RSSZM*M OF 7000
Property Zoning R97 RiMM SINGLE PAIL
Application valuation . 0
-----'=----'- ------------------- -----'---- -----------_-------------- ------
Appl.ication`desa
Neer
Owner -Contractor
------------------------ -- - -
Fayta Rennings £ ttl.en Furford S2=4 VALLEY BLRCTRIC
4020 Newell Road li LONE EAGLE Ltd
APT# ;10. $EQUMM NA 98382
PORE " MA 98363 (360) 681-3330
(360) 4e1=636.9
---FersdCx -'- - ELECTRICA4 WW I€Sslumnnm
Addit onal•desc
Permit Bee 160.00 , plan,Check ree .00.
Issue Data . 5/13/20 valuation e . . . 0
piration Date 11/09/20
Qty Unit Chi Per- Extension
1.00 120.0000 MM ftv-R-SWT FIRST 1300 120.00
140- 40.0000 IM EU-4-B FT AMITIONAL 500 40:00
I
-- - - - ----- - - -- --- - - - - -----------------------
Fee 4u*Wry Cazgod paid Credited Slue
T t 9'ee1Total 160.00 -- -140.60 ----- .00 Ad
Puma Black Total OQ .00 .00 .06
G3Ciitld<Total 1fi0°.Q0 1bd 00 .00 .00
I
77
INSPECTION TYPE DATE: It ULTS: TNSPECTM
DITCH
SERVICE
ROUGH-IN
FINAL
COMMENTS: a} .. 1 - 1r1
PMMt't'WI�IJ WE SIX(6)MONMSFROM LAST WSPWMN
Date:
Sipature ofmmar or-Electrical Contractor X
1 - 2 SINGLE-FAMILY ro
° ELECTRICAL PERMIT APPLICATION 3
+F
Project Address: 1714 W 11 th St.
Project Description: NHC - 1688 SF
E3 Single-Family Residential O Duplex/ARU Building Square footage: 1688
Name: Ka a Hennin s&Galen Furford Email
Mailing Address:4020 Newell Rd.,APT#10, Port Angeles,WA 983d Phone:360-461-6369
Name: Sequim Valley Electric,Inc. License: SEQUIVE9011_3
Mailing Address: 11 Lone Eagle Lane, Sequim,WA 9838s, Expiration Date: 06121/2020
Email: ahanova33@msn.com Phone: 360-681-3330
11212 Unit Charge gy (pt TA((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 $
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 1 $ 120.00
Each Additional 500 square feet" $40.00 1 $ 40.00
Each Outbuilding/Detached Garage $74.00 $
Each Swimming Pool/Hot Tub $110.00 $
TOTAL $ 160.00
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,
05-12-2020 ANDREA HANA
Date Print Name Signature(❑ Owner&? Electrical Contractor/Administrator)
[Electrical Permit Applications may be submitted to City Hail or electricaipermits@cityofpa.us or faxed to 360.417.4711]