The URL can be used to link to this page

Home My WebLink About1727 E 3rd St - BuildingPermit# OH\V Date I phoned the plica The permit Property Own C ontractor I (left a phone or discussed) as expired T.FormsBuilding Division/Project Status Update PROJECT STATUS UPDATE SO inn PX3 at L 5 Z G g at at r will expire soon) What is the status of this project? Please call and schedule a final inspection Or Submit a `permit extension request' letter Or Let me know if the project is abandoned Chfi.PJl sat P,C j o_ 1 Q003 i+ 6 `j P 6 av, P�- zap MO a k 0.0, I )4 --of /170 .r 651-4 'V' a' per S.1?" At 9q02) 4 lb 0 1 0 ktLrSiv0-) 1111 i .tou \Alcri,t4„ '')\J-t\W- 'Illi °'vc f r 4 0_ )6,d_ e,16/1-f \We q3(01-- Se 4c1,77._(0 i it) T 1 M AR 0 I VI\ 8911.0MG S Property Owner PROJECT STATUS UPDATE Permit O Date 3 I f I phoned the Applicant i CiA 1 SO rnerS at Contractor I (left a phone message or(discussed The permit (has expired o (will expire soon) W is the status of this project? Please call and schedule a final inspection Or Submit a "permit extension request" letter Or Let, me know if the project is abandoned t 3 _3. affil ifie.' 4o \A rrne. she_ intr,t<s 4 c k o o�oJe -c 5\1 e_ 1 av OrlirAYkeA e-a.1 rn e 3-3 -11 I(1i C.P Q r'A e 4 (r5 vv .Aiv1 et 24 d oL.RPnnM,- I Si 4 J20AtI. CA<4 ',21)2(v;kk 4Can--r94 CED pru.-#\ 9 cAISLO-4 1)42te.Q. 5 0ritien/ A OA joA T Forms /Building Division/Project Status Update Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type Subdivision Name Property Use Property Zoning Application valuation Application desc TEAR OFF RE ROOF THE GARAGE Owner GOOCHY INVESTMENTS LLC 503 W 3RD ST PORT ANGELES WA 98362 (360) 452 2268 Structure Information 000 000 Qty Unit Charge Per 10 00 Other Fees Fee summary T Forms /Building Division /Building Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 10 00001110 Date 9/30/10 574170 1727 E 3RD ST 06 30 00 5 5 0260 0000 GOOCHY INVESTMENTS LLC description RE ROOF Permit BUILDING PERMIT NO Additional desc RE ROOF THE GARAGE Permit pin number 174540 Permit Fee 80 50 Issue Date 9/30/10 Expiration Date 3/29/11 BASE FEE 3 0500 HND BL -501 2K Charged Permit Fee Total 80 50 Plan Check Total 00 Other Fee Total 4 50 Grand Total 85 00 111(4w' Sl erc RS7 RESDNTL SINGLE FAMILY 1500 Contractor OWNER RE ROOF THE GARAGE PR FEE Plan Check Fee 00 Valuation 1500 80 50 00 4 50 85 00 (3 05 PER C) STATE SURCHARGE 4 50 Paid Credited Due 00 00 00 00 Extension 50 00 30 50 00 00 00 00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) 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 for a 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 co str tion. 9 �1 v c$14 Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) FOUNDATION Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING Under Floor Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow Water AIR SEAL. Walls Ceiling FRAMING. Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION Slab Wall Floor Ceiling MECHANICAL. Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES. Footing Slab Blocking Hold Downs Skirting T.Forms /Building Division /Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 4815 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments PLANNING DEPT Separate Permit #s Parking Lighting I Landscaping I Inspection Type Electrical 417 -4735 Construction R W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 FINAL Date Accepted by FINAL Date Accepted by SEPA. ESA. SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Date Accepted By n �XpI i- 12 -I-11 Applicant Inl Ck Property Owner ilrfOezi. Nortvg .l�Wc�(ivk Property Own 's Ad re 5"'03 W 3 g Contractor r f$& Contractor's Address License Expires Parcel Number Floor Areas PROJECT ADDRESS Basement 1 Floor 2 Floor V 3 Floor Garage Carport Covered Porch Deck Shed Other Max. height of proposed structures Will a lawn sprinkler system be installed? Will a fire sprinkler system be installed? T Forms /Building Division /Building permit application 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 V'27 g_l 3'1 Existing (sq. ft.) Proposed (sa. ft.) LAC Occupancy group Occupant load Construction. type Phone Phone Phone E -mail Lot per sq ft. TOTAL VALUATION I have read and completed this application and know it to be true and correct. I am authorized to that it is my responsibility to determine what permits are required, and to obtain permits prior to workin.; on projects Date 1/30/ l7 Print Name i1i f k& J S 4eV S Signature For City Use Only Date Received —2,o )1) Permit 10 -1110 Date Approved 22W Zoning of bedrooms of full baths of half baths Industrial Project Type Brief Description. EResidential Multi family Commercial Check all that apply New Construction Addition Remodel Repair Demolition 'e -roof House garage other iefear off re -roof lay over one layer Heat System Heat pump wood burning stove gas fireplace pellet stove other Other 0164 LI Total footprint of structures sq ft. '/Lot size sq ft. Lot coverage cyo Site Coverage the amount of impervious surface on' parcel including structur s paved- driveways sidewalks patios and other impervious surfaces (see PAMC 17.94'135 for exemptions) 7 Site coverage ly for this permit and understand Clallam County Assessor Treasurer Property Details 62004 GOOCHY INVESTME Page 1 of 5 Clallam County Assessor Treasurer Property Search Results 62004 GOOCHY INVESTMENTS LLC for Year 2010 2011 Property Account Property ID 62004 Legal Description RICHARDS FG JR SUBD OF SB L14 E2 LT 14 LT 15 W2 LT 16 32A) Geographic ID 0630005502600000 Agent Code. Type Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11 Open Space. N DFL N Historic Property N Remodel Property N Multi Family Redevelopment: N Township Section. QJ Range. �a Location i Address. 1727 E THIRD ST Mapsco PORT ANGELES WA Neighborhood: Cycle 5 Res Map ID 2 Neighborhood CD 10955130 Owner Name. GOOCHY INVESTMENTS LLC Owner ID 27104 Mailing Address. 503 W THIRD ST Ownership 100 0000000000% PORT ANGELES WA 98362 Taxes and Assessment Details Property Tax Information as of 09/30/2010 Amount Due if Paid on Exemptions: NOTE If you plan to submit payment on a future date, make sure you enter the click RECALCULATE to obtain the correct total amount due. Year Statement ID Taxing Jurisdiction 2010 44683 ST SCH STATE SCHOOL 2010 44683 CC -GEN COUNTY 2010 44683 PORT PORT 2010 44683 PORT ANG PORT ANGELES 2010 44683 SD #121 SCHOOL DISTRICT #121 2010 44683 NTH OLY LIB NORTH OLYMPIC LIBRARY 2010 44683 HOSP #2 HOSPITAL #2 2010 44683 WSMET PK DIST WILLIAM SHORE MET PARK DIST 2010 44683 CITY_STORMWATER CITY STORMWATER 2010 44683 WEED_CONTROL WEED CONTROL 2010 44683 TOTAL. 2009 620042008 ST SCH STATE SCHOOL 2009 620042008 CC -GEN COUNTY 2009 620042008 PORT PORT 2009 620042008 PORT ANG PORT ANGELES First Second Half Half Base Base Amt. Amt. Penalty Interest Base Paid $213.68 $213 69 $0 00 $0 00 $213 68 $11372 $11372 $000 $000 $11372 $15 98 $15 99 $0 00 $0 00 $15 98 $263 30 $263.28 $0 00 $0 00 $263 30 $276 78 $276 78 $0 00 $0 00 $276 78 $33 04 $33 05 $0 00 $0 00 $33 04 $46 65 $46 65 $0 00 $0 00 $46 65 $14 84 $14 85 $0 00 $0 00 $14 84 $36 00 $36 00 $0 00 $0 00 $36 00 $0 82 $0 81 $0 00 $0 00 $0 82 $1014.81 $1014.82 $0.00 $0.00 $1014.81 $241 92 $241 92 $0 00 $0 00 $483 84 $122.43 $122.43 $0 00 $0 00 $244 86 $17 34 $17 34 $0 00 $0 00 $34 68 $268 55 $268 54 $0 00 $0 00 $537 09 http. /vpn.clallam. net: 8084 propertyaccess /Property.aspx ?cid =0 &year= 2010 &prop_id =62 9/30/2010 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc Single family residence Owner Somers Mike 1727 E 3RD ST PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Fee summary Permit Fee Total Plan Check Total Grand Total INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS WA 983624909 140574 61 50 1/21/09 7/20/09 Charged 61 50 00 61 50 ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 09 00000069 176242 1727 E 3RD ST 06 30 00 5 5 0260 0000 ELECTRICAL ONLY RS7 RESDNTL SINGLE FAMILY 0 Contractor ELECTRIC SERVICE 82 DRAPER RD PORT ANGELES (360) 452 6424 ELECTRICAL ALTER RESIDENTIAL 61 50 00 61 50 Plan Check Fee Valuation Qty Unit Charge Per 1 00 57 5000 ECH EL BRANCH CIRCUIT WO /FEEDER 2 00 2 0000 ECH EL ECH ADDNT BRANCH CIRCUIT Paid Credited Due 00 00 00 Date 1/21/09 WA 98362 DATE. RESULTS 2 00 00 00 00 0 Extension 57 50 4 00 Signature of owner or Electrical Contractor X Date INSPECTOR. 4k,11) MAR -11 -2005 08 24P FROM ELECTRIC SERVICE City of Port Angeles Permit Application Building DhlslonlElectrlal Inspections 321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98382 Ph: (380) 417.4735 Fax: (380)417.4711 Date: 1 t S 9 1 2 Single Family Dwelling Multi Family or Commercial' Commercial Addition I Alteration Remodel 1 Repair' Description of above Owner Informatin Name: rk I L_ Mailing ddress: SO City: .r t ea Phone: tit 4 'Z License #1 Exp. Unit Charge 93.75 $113.75 $160.00 $205.00 $291.25 2.00 57.50 2.00 72.50 86.25 $116.25 $131.25 75.00 69.00 75.00 50.00 50.00 93.75 80.00 86.25 27.50 57.50 86.25 43.75 S OW% 3 L.) '3. --cD State: U►^ Zip: Slgnatu er el cal contractor or electrical administrator (/r- -e9 Date: t t cr 4526424 RECEIVED JAN 2 1 2009 Thermostat $_Total LIGHT DEPT Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: 11 2 1 a Building Square Footage: TO 4174711 Contractor Information Name: i �e- V ..ti MailinOddre f3 L. I) 4 n-e U titer PO City State: 41b. Zip: 4'd' 4 /..1 Phone: La c I_ Lex... 4s"7__ 1.42 License Exp. Lr� rS m 1 2 ow. Total gy Multiplied by Unit Charge.) ServlcelFeeder 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 S 7.50 Branch Circuit W/O Service Feeder U. Each Additional Branch Circuit Temp. Service! Feeder 200 Amp. Temp. Service/Feeder 201-400 Amp. Temp. ServicelFeeder 401.600 Amp. Temp. Service/Feeder 601 -1000 Amp. Portal to Portal Hourly I Sign /Outline Lighting I Signal Circuit/ Limited Energy Commercial Signal Circuit/ Limited Energy 1 2 Family Dwelling Signal Circuit/ Limited Energy Multi- Family Dwelling I Manufactured Home Connection Renewable Electrical Energy 5KVA System or Less First 1300 Square Ft. Each Additional 500 Square Ft. or Portion of Each Outbuilding or Detached Garage Each Swimming Pool or Hot Tub Owner u defined by RCW.19.28.261: (1) Owner will occupy the structure for Mr years after this electrical permit is finalized. (2) Owner Is required to him an electrical contractor if above said property Is for sale, rent or lease. After reading the above statement, I hereby certify that I am the owner of the above named property or 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 298 -46B, The City of Port Angeles Municipal Cods, and Utility Specifications. CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES WA 98362 Application Number 08 00001568 Date 12/29/08 Application pin number 514592 Property Address 1727 E 3RD ST ASSESSOR PARCEL NUMBER 06 30 00 5 5 0260 0000 Tenant nbr name GOOCHY INVESTMENTS LLC Application type description RE ROOF Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 2800 Application desc RE ROOF LAY OVER ONE LAYER Owner Contractor GOOCHY INVESTMENTS LLC OWNER 503 W 3RD ST PORT ANGELES WA 98362 (360) 452 2268 Structure Information 000 000 RE ROOF LAY OVER ONE LAYER Permit BUILDING PERMIT NO PR FEE Additional desc RE ROOF LAY OVER ONE LAYER Permit pin number 139600 Permit Fee 109 75 Plan Check Fee 00 Issue Date 12/29/08 Valuation 2800 Expiration Date 6/27/09 Qty Unit Charge Per BASE FEE 1 00 14 0000 THOU BL -2001 25K (14 PER K) Other Fees STATE SURCHARGE Fee summary Charged Paid Credited Date T:FormsBuilding Division/Building Permit Due Extension 95 75 14 00 4 50 Permit Fee Total 109 75 109 75 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 114 25 114 25 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 for a 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 ofa 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. f Attc, p J» e t .S tiC 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 Parking Lighting Landscaping 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 SEPA. ESA. SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE 0 09 �t 00 Date Accepted By 1 I xO i U-I f 31 1t C CITY OF PORT ANGELES Attn. Building Permit Technician 321 E. Fifth St. Port Angeles, WA 98362 (360) 4„17-4815 e c (3 1 e_r_ .1 Applicant or Agent .G(bL V kto-(5 u_c- Phone &6-L.(5 2 -ZZW Property Owner U Phone Property Owner's Address 5 63„ t.() egi 3 9f t), A--- q S76. Contractor /Engineer (5 ue'.r dCO F 0\ WOV Phone Contractor /Engineer's Address U License Expires E -mail PROJECT ADDRESS r6 Z7 F `r F Parcel Number 0° BUILDING PERMIT APPLICATION Print in ink erect Type Brief Description. k esidential Commercial Multi- family Industrial Check all that apply New Construction Addition Remodel Repair e -roof I4'Y p(/e(r 1 l a.Ue1' Demolition Heat System Heat pump wood- burning stove gas fireplace pellet stove other Other Floor Areas Existing (sq. ft.) Proposed (sq. ft.) Basement per sq. ft. 1 Floor 2 Floor 3 Floor Garage Carport Covered Porch Deck Shed Other Total footprint of structures I (p) Max. height of proposed structures ft. Occupancy group Will a lawn sprinkler system be installed? Occupant load Will a fire sprinkler system be installed? Construction type Lot Zoning inaIelri cOS y c TOTAL VALUATION For City Use Only Date Received `l --(58 Permit (g 156S Date Approved of bedrooms of full baths of half baths sq. ft. 'T Lot size 100'114r) sq. ft. Lot coverage 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 permits prior to working on projects. p,� c, Date 1 4 21 1 F Print Name VY`l tet e- 0, ✓�'`e- r S Signature (Y6t144 Buyer Seller Settlement Agent: Place of Settlement: Settlement Date: Property Location: Purchase Price County Taxes Escrow Fee Escrow Fee Sales Tax Recording Fees From Buyer APPROVED: Goochy Investments, LLC BY Michael R. Somers, Co- Manager BUYER'S STATEMENT I Goochy Investments, LLC, a Washington limited liability company Dennis E. Brown, Personal Rep Estate of Gary D Brown Advantage Escrow Company (360)457 -3000 802 East First St. Suite 1 Port Angeles, WA 98362 December 30, 2008 1727 East 3rd St Port Angeles, WA 98362 Clallam County Washington DEBITS 12/30/08 to 01/01/09 Clallam County Treasurer Advantage Escrow Company Advantage Escrow Company Clallam Title Company Gross Amount Due From Buyer TOTAL DEBITS CREDITS Deposit or Earnest money Less Total Credits to Buyer TOTAL CREDITS BALANCE Advantage Escrow Company 132,500.00 11.50 300.00 25.20 42.00 132,878.70 1,000.00 1,000.00 131,878.70 (2525/2525/12) ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . 17-000 Date 12/08/17 Application pin number . . . 563915 Property Address . . . . . . 1727 E 3RD ASSESSOR PARCEL NUMBER: 06 -30 -00 -5 -5 -0260 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Kitchen remodel and service ---------------------------------------------------------------------------- Owner Contractor -------------- - --------- BRANDON E AND JACQUELYN M SOME ------------------------ UPPER LEFT ELECTRIC LLC 1727 1306 ROOK DR e 3rd street PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 461-7720 (360) 670-6603 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . Permit Fee . . . . 155.00 Plan Check Fee 00 Issue Date . . . . 12/0.8/17 Valuation 0 Expiration Date . . 6/06/18 Qty Unit Charge Per Extension 7.00 5.0000 ECH EL -BRANCH CIRCUIT W/FEEDER 35.00 1.00 120.0000 BCH EL -0-200 SRV FEEDER 120.00 ---------------------------------------------------------------------------- Fee summary Charged ----------------- ---------- ---------- Paid Credited ---------- ---------- Due Permit Fee Total 155.00 155.00 ,.00 .00 Plan Check Total .00 .00 .00 .00 Grana Total 155.00 155.00 .00 .00 INSPECTION TYPE DITCH SERVICE ROUGH -IN FINAL CONIMENTS: DATE: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION RESULTS: Rt REPORT STATE SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR: W. Signature of owner or Electrical Contractor X Date: CITY OF PORT ANGELES PERMIT APPLICATION; r, ! Building Division/Electrical Inspections `' A 321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362 z. f Ph: (360) 417-4735 Fax: (360) 417-4711 Date: _ 1 & 2 Single Family Dwelling " Plan Review May Be Required, PI om lete Electrical Plan Review Information Sheet Job Address , 7 Building Square Footage: 7' 00c) y. _ Description of above Owner Info�mationContractor e d S Information Name: vw?� U-�.} G Name: ��Cc.:v-4 U �� 'So knAV'A -17 -7 -zW -� Mailing Address: i r ,l Mailingddress: i o C- IC �- cut - Mk City: State: Zip: City: State: GvJ Zip: Phone: Fax: Phone: Ll G t - l 12-0 Fax: License # / Exp. License # I Exp Item Unit Charge QtyTotal (Qty' Multiplied by Unit Charciel Service/Feeder 200 Amp. $120.00 $ CJ 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 $ j. 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 Circuit/ Limited Energy -1 & 2 Family Dwelling $ 64.00 $ Manufactured Home Connection $120.00 $ Renewable Electrical Energy - 5KVA System or Less $102.00 $ Thermostat $ 56.00 $ Note: $5.00 for each additional T-Stat NEW CONSTRUCTION ONLY: First 1300 Square Ft. $120.00 $ Each Additional 500 Square Ft. or Portion of $ 40.00 $ Each Outbuilding or Detached Garage $ 74.00 $ Each Swimming Pool or Hot Tub $110.00 $ — $ C J STotal 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. Signature of owner, electrical contractor or electrical administrator: x / i ` Dated: �.7 % f �7 t