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ELECT
CrTY OF f'QR'
360-417-4735 �
Application Number . . . . 21-00000129 Date 2103/21% `
Application pin number . 996266
Property,Address . . . . 109 N OAK ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-1530-2001-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . .
Property Use . . . . . .
Property Zoning . . . CENTRAL BUSINESS DISTRICT
Application valuation . 0
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Application desc
Meter repair
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Owner Contractor
- -----------
RIAN ANDERSON ANGELES ELECTRIC
12 GREEN VALLEY IN 524 E. 1ST ST.
SEQUIM WA 98382 PORT ANGELES WA 98362
(360) 457-4491 (360) 452-9264
- - -------------------
Permit . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc .
Permit Fee . . . 132.00 Plan Check Fee .00
Issue Date . . . . 2/03/21 Valuation . . . . 0
Expiration Date 8/02/21
Qty Unit Charge Per -- Extension
1.00 132.0000 ECH EL-COM 0-200 SRV FEEDER 132.00
----- ------------- ------
Fee,summary Charged Paid Credited Due
Permit Fee Total 132.00 132.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 132.00 132.00 .00 .00
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REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE DATE: RESULTS: INSPECTOR;-
DITCH
i
SERVICE , D
ROUGH-IN
FINALO'ho
COrs:
PERMIT WML EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
GAEXCHANGEW11 DING
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MULTI-FAMILY / COMMERCIAL
ELECTRICAL PERMIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles,WA 98362 1�
360.417.4735 1 vvww.cityofpa.us I clectricalpermits@cityofpa.us
Project Address: +' 11J .
Project Description: ' t
O Multi-Family Residential ommercial I Industrial/Public Building Square footage:AT
JER INFORM ION
Name: Email:
Mailing Address: Phone: 360--- YAZ_ 111
Name: Angeles Electric, Inc. License: ANGELE1460RS
Mailing Address: 524 E.First Street, Port Angeles,WA 96362 Expiration Date:,2/1/2020
Email: ksimpson@olympus.net Phone: 360-452-9264
INTAILS
Unit Gharae Quantity Total(Quandtv x Unit Charge)
Service/Feeder 200 Amp. $132.00 L__ $
Service/Feeder 201-400 Amp. $160.00 $
Service/Feeder 401-600 Amp. $225.00 $
Service/Feeder 601-1000 Amp. $288.00 $
Service/Feeder over 1000 Amp. $410.00 $
Branch Circuit W/Service Feeder $5.00 $
Branch Circuit W/O Service Feeder $74.00 $
Each Additional Branch Circuit $5.00 $
Branch Circuits 1-4 $86.00 $
Temp.Service/Feeder 200 Amp. $102.00 $
Temp.Service/Feeder 201.400 Amp. $121.00 $
Temp.Service/Feeder 401-600 Amp. $164.00 $
Temp.Service/Feeder 601-1000 Amp. $165.00 $
Portal to Portal Hourly $96.00 $
Sign/Outline Lighting $88.00 $
Signal Circuit/Limited Energy-Multi-Family $88.00 $
Signal Circuit/Limited Energy/First 1500 sf-Commercial $96,00 $
(Note:$5.00 for each additional 1500 sf)
Renewable Elec.Energy:5KVA System or less $113.00 $
Thermostat(Note:$5 for each additional) $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, 1 hereby certify that 1 am the owner of the above named property or a licensed etectrical contractor,t
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.
Ken Simpson
0aV Print Name Signature([] er W Electrical Contractor/Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360A17.47111