HomeMy WebLinkAbout1319 Marie View Drive - Building ELDi� AL PERMIT
CITY OF FORT ANGELES �
30T"7-4735
Application Number . . . . . 21.-00001148 Date 9i13 21
Application pin number . . 012-284'
Property Address . . . . 1319 MARIE VIEW DR
ASSESSOR PARCEL NUMSER: 06-30-01-5-4-0210-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . .
Property Use
._ Property Zoning . . . . . . . RS9 RE$DNTL SINGLE FAm LY
Application valuation . . 0
- - - ------------------- ----------------------------
Application desc
Fireplace circuit
Owner Contractor
--- --- --- -
rJUOMTH & SANDY R SAMPSON OWNER
433 YOSEMITE COURT`
FETT1. CA 94954
(360) 443-6243
Permit . . ELECTRICAL ALTER RESIDENTIAL
Additional desc .
Permit Fee' 63.00 Plan Cheek Fee .00
Issue Date` 9/13/21 valuation 0
Expiration Date 3/12/22
Qty Unit Charge Per Extension
1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00
Fee summary Charged Paid Credited Due
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Permit°Fee Total 63.00 63.00 .00' .00
Plan Check Total .00 .00 .00 .00
Grand,Total 63.00 63.00 .00 .00
REPORT SALES TAX
can your excise tax form
to the.City of Port Angeles
(Lo+ on Code 0502)
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
COM ENU;
PERMIT WILL EXPlltE SIX(6) Fko LAST INSPEC' MON
Signature of owner or Electrical Contractor X Date:
GAEXCHANGOBUtt.DING
1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION 3
Public Works and Utilities Department t�
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 1 N-ww.cityofpa.us I electricalpermits@cityofpa.us
Project Address: 1319 Marie View St Port Angeles, WA 99362
Project Description: Replaced 4 foot Romex with 7 foot Romex for Propane Fireplace Fan/Light Circuit Wiring
L] Single-Family Residential ❑ Duplex/ARU Building Square footage:
OWNER INFORMATION
Name: Ken Sampson Email:ksbbsam@yahoo.com
Mailing Address:8306 N Kyle St, Spokane WA 99208 Phone:360-801-9751
ELECTRICAL CONTRACTOR INFORMATION
Name: Same as Owner License:-
Mailing Address: Expiration Date:
Email: Phone:
PROJECT DETAILS
1tgID Unit Citarae Quantity Total(Quantity x Unit Charge)
Service/Feeder 200Amp. $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 1 $ 5
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. $9300 $
Temp. Service/Feeder 201-400 Amp. $110.00 $
Temp. Service/Feeder401-600Amp. $149.00 $
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly $ -Dt} $
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 addition i $56.06 $
�.. _ TOTAL x$
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.
9/10/2021 Ken Sampson
Date Print Name Signature(VI Owner ❑ Electrical Contractor/Administrator)
[Electrical Permit Applications maybe submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]