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Home My WebLink About515 W 16th St - BuildingPREPARED 1/21/09 8 22 39 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 1/21/09 ADDRESS 515 W 16TH ST SUBDIV TENANT NBR DAVID R ELLEFSON CONTRACTOR DAVID SUE RENOVATION LLC PHONE (360) 452 9848 OWNER DAVID R ELLEFSON PHONE (360) 452 9185 PARCEL 06 30 00 0 4 2580 0000 APPL NUMBER 08 00001463 RES ADDITION PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL99 01 1/21/09 JLL BLDG FINAL January 20 2009 4 29 20 PM 1pangrle SCOTT 775 8144 BLDG FINAL DECK COMMENTS AND NOTES CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 08 00001463 Date 12/04/08 Application pin number 149924 Property Address 515 W 16TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 4 2580 0000 Tenant nbr name DAVID R ELLEFSON Application type description RES ADDITION Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 4000 Application desc REPAIR EXISTING DECK AND INCREASE SIZE BY 13 SF Owner Contractor DAVID R ELLEFSON DAVID SUE RENOVATION LLC 515 W 16TH ST 201 DOGWOOD PLACE PORT ANGELES WA 983627537 PORT ANGELES WA 98362 (360) 452 9185 (360) 452 9848 Structure Information 000 000 REPAIR DECK ADD 13 SQ FT Other struct info HARD SURFACE AREA Permit BUILDING PERMIT RESIDENTIAL Additional desc REPAIR DECK ADD 13 SQ FT Permit pin number 138156 Permit Fee 123 75 Plan Check Fee 49 50 Issue Date 12/04/08 Valuation 4000 Expiration Date 6/02/09 Qty Unit Charge Per BASE FEE 2 00 14 0000 THOU BL 2001 25K (14 PER K) Special Notes and Comments The Fire Department has reviewed the project application and has no comments November 25 2008 3 38 52 PM sroberds The proposal will result in repair of a front deck w /increase of 13 to 19% lot coverage No land use issues anticipated Public Works Utility Engineering has no requirements for this plan review Other Fees Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand Total Date T:Forms/Building Division/Building Permit Extension 95 75 28 00 STATE SURCHARGE 4 50 Charged Paid Credited Due 123 75 123 75 00 49 50 49 50 00 4 50 4 50 00 177 75 177 75 00 00 00 00 00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned fora period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. /2 -O S' 2.009r 114(//0 Fcr sati ie ct Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 -4815 Electrical Inspections 417 -4735 Public Works Utilities 417 -4831 Backflow Prevention Inspections 417 -4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs PLUMBING Under Floor Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow Water AIR SEAL. Walls Ceiling FRAMING Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION Slab Wall Floor Ceiling MECHANICAL. Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I I ESA. Landscaping I I SHORELINE. T.Forms /Building Division /Building Permit Inspection Type Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 FINAL Date Accepted by FINAL Date Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Date Accepted By 4 4 Property Owner Project Type Brief Description: Check all that apply New Construction Addition Remodel Repair Re -roof Demolition Heat System Other Floor Areas Basement 1 Floor 2 Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn. Building Permit Technician 321 E. Fifth St. Port Angeles, WA 98362 (360) 417 -4815 fax (360) 417 -4711 Applicant or Agent l7/9 v /a Etc r s o zJ 0,9 F_ I so, Property Owner's Address ti 5 w /GT 5 Contractor /E- ngineer w S, ,��v Phone ys2 909C Contractor /Engineer's Address 2..6„ A,,, Pt, ?ore T ASWL -f )+4 906 License „aS,Q '3c1.., Expires 2 -i3 -icy E -mail �st'r c'en PROJECT ADDRESS g' 6 T Parcel Number O63O r 25g'o Heat pump Existing (sq. ft.) 4-4 Total footprint of structures 3 4 3 ft. Lot size 7 Max. height of proposed structures /O ft. Will a lawn sprinkler system be installed? F Q Will a fire sprinkler system be installed? I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required, and to obtain prmits prior to working on projects. Date Print Name_ 160 S Signatur c Lot For City Use Only Date Received it--1"1-0g P rmit O to Approved ea 4._T.2_9/ c9c P ne'.6> d!-S 4. Zoning RS r7 r esidential Commercial Multi family Industrial /7G r' 4 UHF of 7 e)/ IhC. hop. co S( In LA (3 Sq Fi wood burning stove gas fireplace pellet stove other Posed (sq. ft.) 0 M n rJ fl 0 per sq. ft. 0054pr 3 0 7/7_ f4-coo /D D ahGmsi 15&K -Frown Its -Fa (3o TOTAL VALUATION 4 Oc7o, o sq. ft. Lot coverage Occupancy group of bedrooms Occupant load of full baths Construction type rtf4r of half baths 1111111111111 Cs-o.rw JOB _ficri_. ge F- L e-> 7 1 1' 1 1 j_ 7" i i i 44_ --i---4A/ 6, 44-t47-' Li F.- 17,1,1,7 'I i 1 1 i 172-' i 1 illi 1 1 r 1 1 1 1 ',.1_ _1_ T r I I .J,_ c r r t -1 il tr l rl i 1 i'l 1 ,-4- r -1---- t 2- 4' -C C 9' 0. P, .4 I .1 1 L t j 1 J. 1.Ni r 1 1 r 't f i J. ,,...1 i 1 it,.._ .7% J ".4'0".. ',..,_1_ 5 I I --1- _L... __i, ,.i ._..1.._ 7 I 1 I i 7-r 5 1 I -t-- 1 „i, i 1 1 1fi I I _:i, -A. 4. _:177_, _L i .1_, 1,, i 1_, 1 Ii I _.r 4 T I _T 4-44 I i 1 _i i 1.__ --41-",L_„__ I 1 I 1 ±-r---.-- t 1 i- 1 1 1,_ 1 A p 1 r. 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I _I, i T --r I i i i 41--" 4 I I, 1 1,.. i 1 4---/- --t• -4- 4 .1._ __i_l_ ...I Li i_ i, 4 4- t_l _1 47 -I --'--1 1---- I -J-1 4- i I t i H 5 4: I 1 1 _I 1 I i „.L.J J 1_ 4 .1 ci i t i 7 I 1 1_ t I- I .i I 1.,_ 1 .---r I .-4 1 I t -1 t 1 f 1 i I I tr H .1- 4,.. 4.. -1 I t 1 i 1 -1- j- 1 1 '7 t_ 1 i i II 1 I 1 i 1 i --t-- k;. s 1 1_ i -i---` I s. i r...._' 1' I f e- I 1 i IT 1, I e j 4,(1 ,-,,,,,,-.7- i e t_____. i ait....._,__ Or 1 n 1 1 I i i ....._...L,......_ i I I 4- t 1-7/ 4.. 0 tiC,"..Cle,_. 1 570e4.i I pg,t 3. -4 1 T; ;--t-, 1-2 i. r i LI i :2. i ....1 4 :,_N 1 n Ire ,,*1 i f: F 1 1 L:r LI 1 1 1 1 4 t -4-,-- j r_i_ i _L 1 r ___1 1 i J i i -1 1 I. 1. i _..1 .1_, _Lt ,J I ,;_i 1 1 t 1 1 1- ,,--k-,1 ft .---t i _,,1 i tL _4 ...1,..,.._.!._ -..1_,. 1 1 1 -----i- r i ,i -1---; 1 J...I. 1 I 1 i 1 4_, 1 E 1 -4 -I --I---. 1 f-r- !----1, 1 ...4._. .„....4.. f ..c0/ -4- I 2.___ i 1 i i• 1 r 1 c` 1- .0. i J i 2 i i T 1 -1. i.- i r t 1 1 i 1 i T t_l, i 1 1 ir i I i 1. T 1 --i- 1 I j, i I 57 I 1 t r!--rrirr SHEET of c. DATE -/9 2 BY JOB _17 t:r 151//‘ 4 £.4. f,y roc 67L0 CPI cps,t: CITY OF PORT ANGELES Construction Piens The Issuance of this permit based upon these plans, specifi- cations and other data shall not prevent the building official from thereafter requiring the correction of errors in said pia^ specifications and other data, or from preventing building operations being carried on thereunder when in 4 violation of all codes and ordinances of this jurisdiction. Approval Date t y Irt .2)43 6:441C- )41‹ i I ig AU 1,,...riale_ G...)ife.. Le> c; _.c.D 141296A-00031 4 i i, 0 r. e <4: p0 t, D A kr I 4 6 5" 4.. /c, G 44.z 51,5 ;4- Croo E.1, 22.' ri IL ...I P 0 oeCi,/ NO 5 4 L SHEET bf DATE 4/ —1.9 --Z0c, BY leto' t 5 2. r4 Ito k).& os CrE- t aS 14 6° (2 7-- t LA G- rb /1/-0 6:X& p-14-cg e d4tz...0 Zs% Z X 6„ r re-m -r0 16 t.-4A Zotr A 640 Roe d 4 trri pro tc-e: c„. /Z, 6- EX- I 5 rf, 0 e_c_L• 15 ra-c2 e 05 Cy-_9 1-^-1-C-1 (S S e,,aro rzi 9 0 2,‘ Le fay lag?" 0E-C 4-- TO C— C r- EEO 7 r c_c) 5 7 &AL 0 L 3ote-- tfilf-r6A-ipICS -7 7W 0 k41 L z /2.Y.12- A DJ /rnf DECIt, R L 501"pat 4- /5 x -roP L. 1 ifo.t.zo (p 2- fic 4-OF r77044-7 4 "7 5 ciPPor2_1 -4 (0- 1 6- It 4QF 8_04_ ELECTRICAL PERMIT J ('\ PERMIT NO. 3 3 L./ '1 //-f',1 cY "7 DATE CITY OF PORT ANGELES LIGHT DEPARTMENT . Site Address: -"" G/~ Installed By: o READY FOR 0 WILL CALL FOR INSPECTION INSPECTION License Number: Phone: ~f . &v-1 Phone: Owner/Business: Sq. Ft. Owner/Business Address: o New Construction o Remodel o Service update/alter/repair ~ Add/alter circuits b Auxiliary power (list below) o Special equipment <list below) o Overhead o Underground Voltage o ll?l 03.0 Service size o Temporary ~ Residential Heat KW o Baseboard 0 Furnace/Boiler o Heatpump 0 Other o Commercial/lndustrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) Amps Details/Description: 1h/07 tLuJ 7j;'iR '.1 ~ . - . . W.S. No. Service Capacity: 0 O.K. 0 Not O.K. o Ditch inspection O.K. o Rough-in/cover O.K. o O.K. to connect service ')IIi. Final O.K. Size Comments Date Hold for: 0 Easement 0 Letter o Signed up for service/meter o Meter Department notified for installation o Fire Department notified of inspection o Plan Review approved/pending Installer: &--vt Permit/Receipt No. !33U New Meters o Site Address: .0 Notily the Department 01 City Light by Street Address and Permit Number when ready lor inspection. Work must not be covered or electrically energized before inspection and O.K. lor covering or service has been given by the In. spector in Writing on the Wiring Report or the Building Permit. PHONE 457.0f411. EXT. 158 or EXT. 224. 'J?i NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT . '."O~. 'k/vV\ ex- Inspector Amount paId WHITE _ file by address YELLOW _ file by number PINK - Top: Eng. Bottom: Customer GREEN - Top: Inspector. Bottom: City Hall _ .n'~'''' "..,..,TFRS. INC. CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT Nt! 17334 Port Angeles. washlngton..___.z:...:::-.....~..___2:-.___.______......___...... 19..T.~ In accordance with the City Ordinance to regulate the Installation. extension, or repair of elec- trical equipment in, on. or about any building or other structure In the City of Port Angeles, per- mission Is hereby granted to dO electrical work as listed below. Address nfrl:S:....j.1)______/.@.uu~nnn..______.______n___. Occupancy___un_____.~~____...u___u___ Owner ka~( f>A ..u-~.rA /d..R..Jk",.4-::C-;... Jilnat.Jl::un___n..___nu____m___._n___nm.______n___.....nu___u__. Wiring C.~:~~~t~~.::2:~R.:>--~---.---~fByu.u.un......muu------.---------..---.-----.---...m.___...u ;l., 0 r 0 Light Outlets..............................._.._..... Service, volts ....................................... 4D Receptacle Outlets............................... Dryer. KW __unnn.fI2..................__....... Range, KW___.___/.lX___n.n___.nn....nw Water Heater: ....,...-. Kw___.______':L.nSnn______n.n___n Hea" KW..n-l-t"nmnnB.6nn Motors: size, volts and phase: 19 I~ ~::::.l:t~::::::::::::::::::::::.::: No. wires ....................................... SIze wlres..................._.............._.. Main fuse ....................................... Enclosure ....................................... Type of wiring: Entrance Cable ................m.......... Rigid Conduit n.nnn.nnn Metallic TubIng ................. Current transformers: No. & Size....................................... Ser. No............................................... Ser. No..............__.............................. Ser. No. ............................................. Type of Wiring: Armored Cable ............................_ Non-MetalUc ................................. Knob & Tube................................_ Rigid Conduit mn__m__n....__mmm__ Metallic TUbing ........................... Raceway ..............................._.___ Circuits, Llght........h.~..................._.. Utlllty __m.m____..~____--mm.....m.n. Heat __........../..__O'______..____.m____ . -L. Range .......................:..................... Water Heater ........2....._............ Motor ............................................_ Dryer ..............................................__ Furnace ..........................h......_........... Total wad............................. Ser. NO.................._........................n Total ........~...~...........n... Remarks: u._________u~m.~.'__--__..-----.--...-------m.uuuu------u---u---u------------.---------.uu--.--- Permit FeeGL-~ .-,2, ~ $.______.___..___.___.______....m.__. Treas. Receipt No..u........uu.u..____u. By ut{2<C~---.~S;r..~~~ NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con- cealed due DoUce must be given the Inspector so that work may be inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT N? 17334 Address..................._.........__........................................................................................................Date..._.........._.._.._.........._.._.._......_......... Owner ..................................._......_.._......_......_.._...........................n.............................. Tenant...........n.n.................................................... WirlngContractor........................._................................_.............................................................By.............................................................. NOTICE-Current must not be turned on until Certificate ot Inspection has been Issued. It work is to be con- cealed due noUce must be given the Inspector so that work may be inspected before concealment. 1M Olympic Printers, Inc. Application Number . . . . . 22-00001558 Date 12/15/22 Application pin number . . . 810106 Property Address . . . . . . 515 W 16TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-4-2580-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc T-stat ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ DAVID AND SALLY ELLEFSON DAVE'S HTG & COOLING SRVC INC 515 W 16TH ST PO BOX 413 PORT ANGELES WA 983627537 PORT ANGELES WA 98362 (360) 461-4121 (360) 452-0939 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . . Permit Fee . . . . 56.00 Plan Check Fee . . .00 Issue Date . . . . 12/15/22 Valuation . . . . 0 Expiration Date . . 6/13/23 Qty Unit Charge Per Extension 1.00 56.0000 ECH EL-LVT-THERMOSTAT 56.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 56.00 56.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 56.00 56.00 .00 .00 1 - 2 SINGLE-FAMILY ELECTRICAL PERMIT APPLICATION Public Works and Utilities Department 321 E. 5th Street, Port Angeles, WA 98362 360.417.4735 I www.cityofpa.us I electricalpermits@cityofpa.us lJ (1) 3 ;:;: ~ Project Address: 515 West 16th Street Project Description: Low voltage thermostat wire for thermostat as part of ducted heat pump installation e'.:J Single-Family Residential □ Duplex/ ARU Building Square footage: ___,/,_,' ( ..... a'--rfO"--=·------------ OWNER INFORMATION Name: Dave & Sally Ellefson Mailing Address: 515 West 16th Street, Port Angeles, WA 98362 Email: _ Phone:3604614121 ELECTRICAL CONTRACTOR INFORMATION Name: Dave's Heating & Cooling Service, Inc. Mailing Address: PO Box 413, Port Angeles, WA 98362 Email: davesheating@wavecable.com License: DAVESHC9912C Expiration Date: _5/_2_02_3 _ Phone: 360-452-0939 P RO JEC T DE TAILS 1wn Service/Feeder 200 Amp. Service/Feeder 201-400 Amp. Service/Feeder 401-600 Amp. Service/Feeder 601-1000 Amp. Service/Feeder over 1000 Amp. Branch Circuit W/ Service Feeder Branch Circuit W/O Service Feeder Each Additional Branch Circuit Branch Circuits 1-4 Temp. Service/Feeder 200 Amp. Temp. Service/Feeder 201-400 Amp. Temp. Service/Feeder 401-600 Amp. Temp. Service/Feeder 601-1000 Amp. Portal to Portal Hourly Signal CircuiULimited Energy - 1&2 DU. Manufactured Home Connection Renewable Elec. Energy: 5KVA System or less Thermostat (Note: $5 for each additional) First 1300 Square Feet ~,....."""m,,,... Each Additional 500 square feet" Each Outbuilding / Detached Garage Each Swimming Pool / Hot Tub Unjt Charge Quantity I2!a.l (Quantity x Unit Charge) $120.00 $ _ $146.00 $ ---- $205.00 $ ---- $262.00 $ ---- $373.00 $ ---- $5.00 $ _ $63.00 $ ---- $5.00 $ _ $75.00 $ ---- $93.00 $ ---- $110.00 $ _ $149.00 $ _ $168.00 $ _ $96.00 $ ---- $64.00 $ ---- $120.00 $ ---- $102.00 $ ---- $56.00 _1----==-- _::,$=5=6=.0=0==------ $120.00 $ _ $40.00 $ _ $74.00 $ _ $110.00 $ TOTAL $ 56.00 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 wner of e above named property or a licensed electrical contractor. I am making the electrical installation or alteration in complianc wit thee tri I laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296- 468, The City of Port Angeles Municipal Code, and Utility S 1211412022 Laci Williams Date Print Name ignature (0 Owner t2' Electric Contractor/ Administrator) [Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711] PREPARED 12/14/22, 7:46:03 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:22-00001558 515 W 16TH ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL ALTER RESIDENTIAL 56.00 TOTAL DUE 56.00 Please present reciept to the cashier with full payment ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: T-stat NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 12/19/2022 22-1558 TAP OWNER CONTRACTOR Dave’s Heating PROJECT ADDRESS 515 W 16th St Application Number . . . . . 22-00001549 Date 12/13/22 Application pin number . . . 627788 Property Address . . . . . . 515 W 16TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-4-2580-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc DHP ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ DAVID AND SALLY ELLEFSON EXTRA MILE TECH & ELECT., LLC 515 W 16TH ST 418 N. RACE ST. PORT ANGELES WA 983627537 PORT ANGELES WA 98362 (360) 461-4121 (360) 457-5222 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . . Permit Fee . . . . 68.00 Plan Check Fee . . .00 Issue Date . . . . 12/13/22 Valuation . . . . 0 Expiration Date . . 6/11/23 Qty Unit Charge Per Extension 1.00 5.0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 5.00 1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 68.00 68.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 68.00 68.00 .00 .00 1 - 2 SINGLE-FAMILY ELECTRICAL PERMIT APPLICATION Pub! ic \Yorks and ULili ties Department 32 l E. 5th Street. Port ;\ngeles. WJ\ 98362 300.417.47]5 ! www.cilyofjJa us I electricalpcnnitsr21/cityofpa.us Project Address:-------------------------------------- Project Description:--------------------------------------□Single-Family Residential D Duplex/ ARU Building Square footage: _______________ _ OWNER JNFORMATtON Name: ________________________ Email: ______________ _ Mailing Address: ________________________ Phone: ___________ _ ELECTRfCAL CONTRACTOR fNFORMATION Name: ___________________________ License: ___________ _ Mailing Address: ________________________ Expiration Date: ________ _ Email: Phone: ___________ _ PROJECT DETAILS Item Unit Charge Qy51ntit3£ :To1s.l (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 CircuiULimited Energy - 1 &2 DU. $64.00 $ Manufactured Home Connection $120.00 $ Ren ewable Elec. Energy: 5KVA System or less $102.00 $ Thermostat (Note: $5 for each additional) $56.00 $ First 1300 Sql;Jare Feet $120.00 $ 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- 468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator) [Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us] '"'CJ CD PREPARED 12/12/22,13:16:44 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:22-00001549 515 W 16TH ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL ALTER RESIDENTIAL 68.00 TOTAL DUE 68.00 Please present reciept to the cashier with full payment ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: DHP NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 12/15/2022 22-1549 TAP OWNER CONTRACTOR Extra Mile Electric PROJECT ADDRESS 515 W 16th St