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'ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number . . . . 21-00000952 Date 8/09/21
Application pin number 727352
Property-Address . . 1432 W 4TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-1-2230-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . .
Property Use . . . . . . .
Property,Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
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Application desc
T-stat DHP
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Owner Contractor
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HENDRICKS, RONALD DAVE S HTG &COOLING SRVC INC
1432 WEST'4TH STREET PO BOX 413
PORT ANGELES WA 98363 PORT ANGELES WA 98362
( 45) 1641 (360) 452-0939
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Permit . . . ELECTRICAL ALTER RESIDENTTIAL
Additional desc . .
Permit Fee . . . . 56.00 Plan Check Fee .00
Issue Date . . . 8/09121 Valuation . . . . 0
Expiration Date 2/05/22
Qty Unit Charge Per Extension
1.00 56.0000 ECH EL-LVT-THERMOSTAT 56.00
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Fee summary Charged Paid Credited Due
Permit Fee Total 56.00 56.00 00 .00
Plan Check Total .00 .00 ..00 .00 =
Grand Total 56.00 56.00 .00 .00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
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FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
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1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362 1
360.417.4735 1 www.cityofpa.us I electricalpermitS@cityofpa.LIS --J)
1432 West 4th Street, Port Angeles, WA 98363
Project Address: g
Project Description: low voltage thermostat wire for controller as part of ductless heat pump system installation
LI Single-Family Residential ❑ Duplex/ARU Building Square footage:
OWNER INFORMATION
Name: Ron 8 Lisa Hendricks Email: rlsallinggyahomoom
Mailing Address: 1432 West 4th Street, Port Angeles,WA 98363 Phone: 360-461-4644
ELECTRICAL R INFORMATION
Name: Dave's Heating&Cooling Service,Inc. License: DAVESHC9912C
Mailing Address: PO Box 413,Port Angeles,WA 98362 Expiration Date: 5/2023
Email. davesheating@wavecable.com Phone: 360452-0939
PROJECTDETAILS
12M Unit Charge Quin= j&I(Quantity x Unit Charge)
ServicelFeeder 200 Amp., $120.00 $
Service/Feeder 201-400 Amp. $14&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 14 $75.00 $
Temp.ServicelFeeder 200Amp. $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 $ 56.00
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,
8/3/2021 Heather Navarre V-11-
Date Print Name Signature(❑ Owner V Electrical Contractor/Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.47111