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lication Number .' '20-60000fi39 aa%%E�l+ T T" x
Lotion gist number 1S6472
ddresa 1316 8 7Rg30
Assam O�-Jfl=31- - -01 0-0000-: to ft C;ity of Part kwXeS
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Pravem'k Zoning _ RS7 RXSDNTL 91S=X'FAMIT Y
A4i7 *tioh valuation 0 .
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owner CbutraCtgr
-yPMILY 2012-RSV;1'IST -SLI&MIC-- -
6, l M ST 2:CaYdoLAIEdB UiAY .
PQ ,SS. 1i1�, 9$3.6 SBS UIM WA 90382
t30}.+351-3639 3360) 477-2202
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Ada- , 1 desc 14� $
Play c4eck Fees .00
ZOSO ate. 6J2t;i6 valuation 0
BxPira# i5a Date 14�210
Vn3t Charge Per Rxtension
F� 75.00
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A3SE �. E.. DATE: CULTS: ECTt3R:
SE�CE
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PERMWI t�l I ME 5 M k8 IMM LAST MPWTION-
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A t3�K �~ �L '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
360.417.47351 www.cityofpa.us I eicctricalpcnnits@cityofpa.us
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Project Address: 4, ` A 2
Project Description: t a Sin le-Famit Residential O Du lex/ARU Building Square f tage:piligil III
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Name: t^a Email: '—'T�W --ael-S S2� G �
Mailing Address: 1 20 E� 7'�`^ �a�r-'j err Sgr��2S Phone: 36 3 o
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Name: e. c. ic, C— License: A-kQ c�
Mailing Address: c a1a:t he_ Expiration Date: 16 -,_I�
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Email: "�� a ��av ,+r r-_.�� c c C a n.cam"Y�^, Phone: 3� `I�Z
IkIn Unit Charge OuanI L JQW(Quantity x Unit Charge)
ServicefFFeeder 200 Amp. $120.00 $
Service/Feeder 201-400 Amp. $146.00 $
Service/Feeder 401-6W Amp. $205.00 $
ServicelFeeder 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 $6.00 $
Branch Circuits 1-4 $75.00 $ ..7
Temp.Service/Feeder 200 Amp. $93.00 $
Temp.Service/Feeder 201400 Amp. $110.00 $
Temp.Service/Feeder 401-6W 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 $
Each Additional 500 square feet" $40.00 $
Each Outbuilding/Detached Garage $74.00 $
Each Swimming Pool/Hot Tub $110.00 $
_ TOTAL
Owner as defined by RCW.19.28.261:(1)Owner wig occupy the stricture 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 Specification andPAMC1 .05.050 regarding Electrical Permit Applications.
D'ate Print Name Sig atu (EMwnerElectrical Contractor/Administrator)
(Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]
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