HomeMy WebLinkAbout - Building (53) ELE&R AL PERMIT
CITY Of#ORT ANGELES
3 f-417-4735
Application Number . . . . . 21-00000933 Date 7/29/21
Application pin number . . 345348 Property Address . . 1011 W 12TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-3-5380-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . .
Property Use . . .
Property Zoning . . . . . .
Application valuation . 0
Application desc
JettedTub----------------------------------------------------------------------------
Owner Contractor
OLSEN SHEILA BLACK DIAMOND ELECTRICAL CONTR'
1011 W 12TH ST 502 BLACK DIAMOND RD
PORT ANGELES WA 983637263 PORT ANGELES WA 98363
(360) 565-10.35
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Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc .
Permit Fee . . . . 68.00 Plan Check Fee .00
Issue Date 7/29/21 Valuation . . . 0
Expiration Date . . 1/25/22
Oty Unit Charge Per Extension
1.00 5.0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 5.00
1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00
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Fee summary Charged Paid Credited Due
Permit Fee Total 68.00 68.00 .00 .00
Plan Cheek Total .00 .00 ._00 .00
Grand Total 68.00 68.00 .00 .00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0542)
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
}A` SERVICE
ROUGH-IN
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 3
Public Works and Utilities Department N
321 E. 5th Street, Port Angeles, NV.-k 98362
360.417.4735 1 www.cityofpa.us j electricalpennits@cityofpa.us VA
Project Address: 1011 W 12th Pacific Bath
Project Description: Jetted Tub wiring
n Single-Family Residential ❑ Duplex/ARU Building Square footage:
OWNER INFORMATION-
Name: Email
Mailing Address: Phone:360-457-5887
ELECTRICAL CONTRACTOR INFORMATION
Name: BDE License: blackec894d2
Mailing Address: Expiration Date:
Email: Phone:360-461-3957
PROJECT DETAILS
1tlim Unit-Charoe . Quantity Total(Quantity x Unit Charge)
Service/Feeder 200Amp. $120.00 $
Service/Feeder 201400 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 1 $
Branch Circuit W/O Service Feeder $63.00 1' $
Each Additional Branch Circuit $5.00 $
Branch Circuits 1-4 $75.00 $
Temp. Service/Feeder 200 Amp. $93.00 $
Temp. Service/Feeder 201400 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. $6400 $
Manufactured Home Connection $120.00 $
Renewable Elec. Energy: 5KVA System`oriess $1102.00 $
Thermostat(Note: $5 for each additional)
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. j
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.
7-27-2021 Benjamin Shamp
Date Print Name Signature(;6 Owner ❑ Electrical Contractor/Administrator)
[Electrical Permit Applications maybe submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]