HomeMy WebLinkAbout1201 W 5th St - Building
ELECTRICAL WORK PERMIT APPLICATION
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Installation description ~
Cl Commercial 0 Residential
Electrical contractor name
License number
o Electrical Contractor 0 Owner
Date Expires
o New "Altered/Addition
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Owner as defined by RCW: /9.28.261:(1) Owner will occupy the structure for 111'0
years aJter this electrical permit is finalized. (2) Owner is required to hire an electrical
conlraclOr if above said property is for sale. ren( or lease.
Arter 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 instal-
lation 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.
Signature
Job wired by
Purchaser's mailing address
City
State ZIP
Telephone number
FAX number
Premises owner's name
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Address of inspection
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Phone number fo schedu
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o Credit Card Visa Mastercard
Discover
Card #
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Date:
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Expiration Date
of card
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Service Information
Electrical Load Ad ons and o. ubtractions
o NO LOAD CHANGES
o Baseboard KW
o Furnace KW
o Heat Pump Ton LAR
o Fan-Wall KW
o Overhead Service
o Temp Service
o Underground Service
Voltage
PhaseD1D3
Service Size:
Feeder Size:
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735
ROUGH-IN
Dale Appro,"edBy../
FINAL
Dale Approved Hy
Inspection
Date
/' THERMOSTAT
"- DalC Approvcd By
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"- Dale Approved By ,.,/
SERVICE
DalC Approved By
FEEDER "
Dale Approved By
Area, Building or Equipment Inspected
Action Taken
Electrical
Inspector
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 983(,2
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property zoning
Application valuation
06-00000570 Date
093080
1201 W 5TH ST
06-30-00-0-1-1565-0000-
ELECTRICAL ONLY
6/12/06
o
Owner
Contractor
DINZART MICHAEL J
1201 W 5TH ST
PORT ANGELES
OWNER
WA 983632005
Permit
Additional desG
Permit pin number
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
OWNER! MOVE METER TO GARAGE
78881
66.90 plan Check Fee
6/05/06 valuation
12/02/06
.00
o
Qty Unit Charge Per
1.00 66.9000 ECR EL-R OR RM 0-200 ALT SRV FDR
Extension
66.90
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 66.90 66.90 .00 .00
Plan Che ck Total .00 .00 .00 .00
Grand Total 66.90 66.90 .00 .00
COMMENTS/ACTION NEEDED