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- 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles,`WA 98')62 X
360A 1 T47 3i , wwN__=Citvofpa.us ; elecrriCalpenni Citvofpa.tls
Project Address:
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P;royje t Description: r1
Single-Family Residential ❑ Duplex/ARU Su(ding Square footage: /w/v
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Name: Jf ,y Email:
Mailing Address:' rf-' Phone: Z -Zf
Name: Angeles Electric, Inc License:ANGELE1460RS
Mailing Address:524 E First Street, Port Angeles,WA 98362 Expiration Dater
Email:ksimpson@olympus.net Phone:360-452-9264
bm Unit Charge
3Qt;tl(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 $
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 $
First 1300 Square,Feet $120:Otl $
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 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 Thy City of Port Angeles Municipal Code,and Utility Specifications and AMC 14.05.050 regarding Electrical Permit Applications.
!1
Ken Simpson
ate Print Name Signature( Owner' Electrical Contractor/Administrator)
(Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]