HomeMy WebLinkAbout1010 W 13th St - Building
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FEE RECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
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PERMIT NUMBER
CONT. LIe. NO.
TIME TO COMPLETE
NO. STORIES
LEGAL OCCUPANCY
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TOTAL FEE
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Site Address
ELECTRICAL PERMIT ONLY .10 OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
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~ JS RESPON~ 01: A~S4NT _ -hERMITS WITH WRONG ~ODRESSE~ ARE CAN
t?l .-/ a ~ ~nstallation By
Installers Address
Installers Phone
ada for permit to install Electrical Equipment as follows:
Owner
Owner's Address
Wiring Method )1 'h/[ IS
.
NUMBER AMP 240V NUMBER AMP 120V 240V
USE OF CIRCUIT PER 120V 100R FEE USE OF CIRCUIT PER 100R FEE
CIRCUITS 10 CIRCUITS 10
CIR 30 CIR 30
LIGHT SIGN
LIGHT . 50 VOLTS
OR LESS
CONVENIENCE . MOTOR
CONVENIENCE MOTOR
APPLIANCE MOTOR
DISHWASHER FIRE A_~ARMS
DISPOSAL BURGLAR ALARM
RANGE MISC.
OVEN
WATER HEATER
LAUNDRY .
.
. REINSTALLATION LIGHT FIXTURE #
DRYER
FURNACE , SUB TOTAL FEE
GAS - OIL
FURNACE ENERGY FEE
ELECTRIC BASIC FEE
ELECTRIC HEAT .-5~ ~~ W 1<. I~ .
TOTAL FEE
ELECTRIC HEAT . SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
..
A.C. UNIT d?J tJ AMP / PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE ~ /#~ A.W.G.
I SUB-TOTAL SIZE OF GROm:J'O ./ SIZE OF ENTRANCE SWITCH
Date Application made
~
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,19 0'7
I certify that the work to be performed under this permit witl be done by the installer and in co
By
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CONTRACTOR OR OWNEf:l (OR AUTHORIZED AGENT)
Permission is hereby given .to do the above described work,_according to t~_e conditions hereon and according to the approved plans and
specifications pertaining thereto, subject to compliance with the o::nanceJ)hJ;r~t:::_G~ '
Date Permit Issued ) Iti~ 7 PLANS L::iED r. .\
Nol ~ep rtment of City Light by Street Address and Permit Number when ready for inspection. Work must not
be covere or current turned on before inspection and 0 K for covering or service has been given by Inspector in
Writing on Permit Placard. A.. Permits Phone: 457-0411 Ext. 158.
PERMIT PLACARD MUST BE KEPT POSTED ONTHE.WORK - SEE OVER-
WARNING
WHITE. Original CANARY. Duplicate PINK. Tripiicate WHITE CARD. Inspector's Report
OLYMPIC PRINTERS. INC.
DATE OF VISIT
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REPORT OF INSPECTOR
REMARKS
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O.K. FOR CC;WERING
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Application Number . . . . . 22-00000539 Date 5/09/22
Application pin number . . . 786285
Property Address . . . . . . 1010 W 13TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-3-9610-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RESIDENTIAL HIGH DENSITY
Application valuation . . . . 0
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Application desc
Service
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Owner Contractor
------------------------ ------------------------
TRACY AND MICHELLE HOLLISTER SEQUIM VALLEY ELECTRIC
2371 W SEQUIM BAY RD 11 LONE EAGLE LANE
SEQUIM WA 98382 SEQUIM WA 98382
(360) 681-3330
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Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 120.00 Plan Check Fee . . .00
Issue Date . . . . 5/09/22 Valuation . . . . 0
Expiration Date . . 11/05/22
Qty Unit Charge Per Extension
1.00 120.0000 ECH EL-0-200 SRV FEEDER 120.00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 120.00 120.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 120.00 120.00 .00 .00
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
COMMENTS:
Service
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
5/24/2022 22-539 TAP
OWNER
CONTRACTOR
Sequim Valley Electric
PROJECT ADDRESS
1010 W 13th St