HomeMy WebLinkAbout4021 C St - Building
CITY OF PORT ANGELES
LIGHT DEPARTMENT
N~
18201
ELECTRICAL PERMIT
Port Angeles, washlngton.__m__m,J__.=_.~m~__m_mhm_, 19.~
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-
=::;~:~ai#~~~::~:::::=
Wiring con~/}__r.'_'_'h...._...____m._._mm_m_n__.m. By..~~_~_::2?,1_("Y~__hm____
Light Outlets.........__...................__.._.....
Service, volts _.....__..................n_n___.....
Receptacle Outlets......................n.......
Dryer, KW nnnn._n_n_....__n._..n__....__..._
Range, KW....___h___.nn_______._____
Water Heater:
No. wires nnnn.n..............._.n_.n.nn
Type of Wiring:
Armored Cable ...mm._n___n__..........
KW.m.mn.nnmnmn.....nmmmmn
Size wires..................n_..._n........_..
Main fuse m.___.n............n.....n___..m
Heat: KW..................n......................n..n...
Motors: size, volts and phase:
Current transformers: ~
No. & sizenn~non.m. 9 non..
Ser.No. _ _.__.m m . m _ 0000
Ser. NO'~~ n n nno
Remark:~ta:n~~~__:~_____..n__._:_~:::.::_m__h.m____:~:&~_::.___~_____::_::h__mm__mnh_h~_~~_~:__~::~___~.:..:::~:::.:::~:::.:::~:
Range .00__ 0000._......_.. _00_.................
Water Heater ....nnnnnnnnnn___m.
Motor .._..........__..._________.___._....__.__...
DTyer.......n........nnn_.nnnn__..nn......_
Furnace. ._00._................._00.._ _00..___00
..-..._............._--...............~....................--.--.-.................-.--............-.----.---............................--...-......................--.......--
;~~2:-::~~---~~~
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con.
cealed due notice must be given the Inspector so that work may be inspected betore concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
'-/D~ /
\
- S (! ELECTRICAL PERMIT
'c '41 $;L~ . .5 y?Jy
:::;~.f~~~~_=:-i!-=~
NOTIC~urrent must not; be turned on until Certificate of Inspection has been issued. It work is to be con.
cealed due notice must be given the Inspector so that work may be inspected betore concealment.
N~
18201
1M Olympic Printers, Inc.
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
App.lication Ni,.imber I . . o .
16 0000071.0 Da L e
Applicat..i.on 1pin. rnimber
773460
Property Address . . .
4021 C ST'
ASSESSOR PARCEI., NUM13Ek
06 30 09 5 0 9100 0000
type deucir.A.pLion.
12l, F, C, ml: CA I., ONLY
Subdivis..i.on. Uarne
PORT A.NGJ3F..,ES
Property
Property, Zoni.n.g
UNKNOWN
Appl..Lcatil.ori. valu.aL.J.on
0
Appli'..cat.i.On desc
Meter. Y..epair
Permit F ee
5/ 17/16
Owner
C 0 rl. t Y.: a c t. o r
Dq(.J[.IJGEP,.STEPHEN C
INSPECTOR:
ANGEL&S ELECTRIC'
3891. OBRIEN RD
524 E. IST ST.
PORT ANGEE�ES
WA 983627426
PORT A.NGJ3F..,ES
(360) 4!:i2....926 4.
Permit
ET...,ECTRF.CAT..., ALTER
RESIDENTrAl,
Addi Ll onal. desc
FINAL
Permit F ee
120.00
P.Lan Check Fee
Issue. Date
5/17/1.6
Valiaal.'A.on
Expirai.Aon Date
11./1.:3/1.6
Ly Ai.t charge
[) e r
F, 'n
1.00 1.20, 0000
ECH FIC, -0-2007
SRV ;EEDER )0
Fee summary I i
a:r. g ed
Paid cr e d i. t e d n,;
Penn.j.t. Fee Tc)tal.
120.00
120,00 00 (:0
P.Lan. Check. Total
.00
.00 00 00
G:),.and Tot al
120.00
120,00 1 00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
FINAL
ii 1
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
GAFXCHANGMBUILDfNG
f
CITY OF PORT ANGELES PE "I° APPLICATION`
Building Division/Electrical Inspections
321 East With Street.— P.O. Box 1150 / Port Anwg es Washington, 98362
Ph: (360) 41 -475 Fax: (360) 4174711
Date:Z1 4 2 Single Family Dwelling
qa�
* Plan Review May Be Required, Please Complete Electrical.Plan Review Information Sheet
Job Address: Y�A
Building Square Footage:, r N
Description of above
Info aq
rrr Info
� ,
Nary 8:
N
g -A ..........
IV I
Ctly State: dip:
Clly !p '
der 21p
Ptrone:_ Fax*
Phone
ax
License # l Exp.
lJouxpa # i Earp,
777-
Item
Unit Charas
QbLMUW91�
Service/Feeder 200 Amp..
$120.00
$
Service/Feeder 201-000 Amp.
$146.00
Service/Feeder 401-600 Amp
$ 205.00
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 14
$ 75.00
Temp. Serviod Feeder3.00
0100
—
Temp. Service/Feeder Amp.
110.00
Temp.
Servic0eeder 401.600 Amp.
$149.00
$
Temp. Service/Feeder 601-1000 Amp.
$166.00
Portal to Portal Hourly
$ 96.00
Signal Circuitf Limited Energy -1 & 2 Family Dwelling
$ 64.00
Manufactured Home Connection
$120.00
Renewable Electrical Energy - 51NA System or Leas
$102.00
Thermostat
$ 56.00
Note: $5.00 for each additional T-Stat
QNSTRUCTION;
1300First Square
$120.00
Additional 500 Square FL or of $40.00
Each $'
Each Outbuilding or Detached Garage $ 74.00
Each Swimming Pool or Hot Tub $110.00 �
Total 6.
Owner as defined by RCW.19.26.261: (1) Owner will occupy the structure for two years Wier this elechtCW permit Alixed. (2) Owner is required
to hire an electrical contractor if above said property is for sale, rent or lease. Pam* expires after six months of 1 nspe&jon.
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 296468, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Signature of owner, eleWcal contractor or electrical administrator: ❑ cat+ 0 chak
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