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ELE6-ixAL PERMIT
CAY ' ' TGELES
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Application Number 21-00000505 Date 4/27/21
Application pin number . . 958020'
Property Address . . . . . 1311 ROOK DR
AS$ESSOR PARCEL NUMBER: 06-30-14-6-7-0250-0000-
Application"type description ELECTRICAL ONLY
'Subdivision Name . . . . ..
Property Use ,
Property Zoning . . . . . RS9 RESDNTL SINGLE FAMILY
Application valuation . . . . 1 0
---- - - - ---- - -------- ---- ----- - ----
Application des-
Tamp, service
Owner Contractor
JASON RAY AND JODI-LEE DBMOTT UPPER. LEFT ELECTRIC LLC
1512 Aurora Ct 1306 ROOK DR
PORT 11NGELES WA 98363 PORT ANGELES WA 98362
(360) 461-6475 (360) 461-7720
------------ --.-.-------------•--------------------------------------------
Permit . . . ELECTRICAL TEMPORARY SERVICE
Additional desc .
Permit-Fee 93.00 Plan Check Fee .00
Issue Date 4/27/21 Valuation . . . 0
Expiration Date 10/24/21
Qty Unit Charge Per Extension
1.00 93.0000 BCH EL-TEMP SRV 0-200 SRV FUR 93.00
----------- ----------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- - --
Permit Fee Total 93.00 93.00 .00 .00
Plan Check Total 00 .00 .00 .00
Grand Total 93.00 93.00 .00 .00
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K REPORT SALES TAX
on your excise tax farm
to the City of Port Angeles
(Loceflon Code 0502)
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INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH''
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, WA 98362
360.417.4735 1 www.cityofpa.us electricalpermits�4�citvofpa.us Qe
Protect Address.
1311 rook rd
Project Description: temp power
❑ Single-Family Residential ❑ Duplex/ARU Building Square footage:
Name: Jason demont Email
Mailing Address: Phone::
Name: upper left electric License:
Mailing Address: Expiration Date:
Email: upperleftelectric@omaii.com Phone:
IIQM
Unit Gharae_ Quantity Tota1(Quantity x Unit Charge)
Service/Feeder 200 Amp. $120.00 $
Service/Feeder 201-400 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 $
Branch Circuit W/O Service Feeder $63.00 $
Each Additional Branch Circuit $5.00 $
Branch Circuits 1-4 $75.00 $
Temp. Service/Feeder 200 Amp. $93.00 1 $ 93
Temp. Service/Feeder 201-400 Amp. $110.00 $
Temp. Service/Feeder401-600Amp. $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 $
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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.
4/24/21 chace botero
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 360.417.4711]
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ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
COMMENTS
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
11/27/2023 21-593
TAP
OWNER
CONTRACTOR
Dave’s Heating
PROJECT ADDRESS
1311 Rook Rd