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360-417=4735
Application Number . . 19-00001S83 Date 1/09/20
,`Application pin number 054614 REPORT STATE SALES T
Property Address . . . . . 637 MARINE DR on your excise tax form .
ASSESSOR PARCEL•NUMBER: 06-30-99-0-0-3720-0000- -
Application type descriptil* ELECTRICALS ONLY tO the City Of Port Angeles
Subdivision Name . . . .Property Use (Location Code 0502)
. .
Property Zoning . . ) . INDUSTRIAL HJAVY
Application valuation . 0
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Application desc
Annual Electrical_Block;'Permit $1154.50
Owner Contractor
-
WESTPORT LLC OWNER
16201 R MAIN ST
CUT OFF LA 70345
(360) 452-5095
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Permit ELSM- ICAL ALTER COMMERCIAL
Additional d®sc . ANNt7212,A3LECTRICAL BLOCK PERMIT
Permit Fee 1154:50 Plan Chock Fee .00
Issue Date 1/09/20 Valuation . . 0 '
Expiratiod Date 7/07/20
oty Unit Charge Per Extension
BASE FEE 1154.50
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Fee summary Charged ,`" Paid Credited Due
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Permt. Fee Total 1154.50 1154.50 00 00
Plan.`Check. Total 00 .00 .00 .00 ,
Grand Total 1154:50 1154.50 .00 .00
INSPW TION r&E DATE: RESULTS: INSPECTOR:
DITCH-
SERVICE
ROUGH-IN
FINAL
COMMENTS:
PERMIT w[LL mem SIX(6)Mowm FROM LAST fi spwriON
Signature of owner or Electrical Contractor X Date: