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Home My WebLink About201 W 1st St - BuildingELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 16-00000659 Date S/23/16 Application pin number 983962 Property Address . ..� 201 W 1ST ST ASSESSOR PARCEL NUMBER: 06 -30 -00 -0 -0 -1480 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . Property Use Property Zoning CENTRAL BUSINESS DISTRICT Application valuation . . . 0 Application desc Coffee Bar Owner Contractor T1NE CONSTRUCTION SERVICE LLC OWNER PMB 507 SAMMAMISH WA 980'757253 ---------- Permit ELECTRICAL ALTER COMMERCIAL DATE: RESULTS: Additional desc 1-4 CIRCUITS Permit Fee 86.00 Plan Check Fee 00 Issue Date 5/23/16 Valuation 0 Expiration Date 11/19/16 - — ------------- COMMENTS: Qty Init Charge Per Extension 'BASE FEE 86.00 Fee summary Cha:�.,.ged Paid Credited Due Permit Fee Total 86.00 86.00 .00 Plan Check Total 00 .00 .00 00 Grand Tot.a] 86.00 86.00 00 REPORT SALES TAX on your excise tax form to the City of Pod Angeles (Location Code 0502) INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN FINAL - — ------------- COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INaPECTIQN Signature of owner or Electrical Contractor X Date: G:\EXCHANGE\BUILDING WIRING r L IJr z 9 417-4735 RK APPROVED NO'S"' ,PP"IOV .i ...,„.ro.�.,....�„..... DITCH .......,,„..��... IIS....,...,.,,,,....ROUGH IN/COVER ......,.,s�„„ . Ifs„ ........ SERVICE . w . , ........ FI'NAII, . ..... OR- w�... ..... ..... ...._..................... NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED wrrHIIN 15 DAYS ,,,,,,,,,,,,,,, DO INOT REMOVE - d cw ��rts �V CITY OF PORT ANGELES PERMIT APPLICATION`S Building Division/Electrical Inspections 321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362 Ph: (360) 417-4735 Fax: (360) 417-4711 Date: _...... _ Multi -Family or Commercial* * Plan Review May e Required, Please Cort Aete Electrical �4n Review Infor • ation tweet tr° Job Address; '��- _---- . Building Square Footage: _... �.—__._ .................. _____...._� Description of above` = m��w.–_ �� a _. ......... ...... llozc--_ ----- .. Owner Infolmation , Contractor Information t Name: s _ Maalie Address Mailing Address City Ci }�° State: ��... ZiP: _.��......, ty:..... ------- ___-- State: Zi p: Phone: Z ax: Phone: ........Fax: ..... .... License # I Exp._....... License # I Exp. Item Unit Cham 9--ty Total LQty MuldRilied by Unit Charge/ Service/Feeder 200 Amp. $132.00 ...............°____ $� Service/Feeder 201-400 Amp. $160.00 $„ Service/Feeder 401-600 Amp $ 225.00 $ Service/Feeder 601-1000 Amp. $ 288.00 $_.__ Service/Feeder over 1000 Amp. $ 410.00 $ ------------------------ _____Branch BranchCircuit W/ Service Feeder $ 5.00 $ Branch Circuit W/O Service Feeder $ 74.00 Each Additional Branch Circuit $ 5.00 $_ Branch Circuits 1-4 $ 86.00 _� $�j _ 'rN Temp. Service/ Feeder 200 Amp. $102.00 $._____________________ Temp. Service/Feeder 201-400 Amp. $121.00 $_ Temp. Service/Feeder 401-600 Amp. $164.00 Temp. Service/Feeder 601-1000 Amp . $185.00_ $m Portal to Portal Hourly $ 96.00 $ Sign/Outline Lighting $ 88.00 _._._......_-, $ Signal Circuit/ Limited Energy - Multi -Family $ 64.00 $w _ Signal Circuit/ Limited Energy / First 1500 sf - Commercial $ 96.00 $_......................„ Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5KVA System or Less $113.00 ......... $ Thermostat $ 56.00 _ .................................. $ Note: $5.00 for each additional T-Stat $ 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 296-4613, 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: ❑ Cash ❑ Check a ❑ Credit Card # x Dated:�...°.................................... ....._....._.._.. 0110112012 ELECTRICAL PERMIT CITY OF PORT ANGELES 360417-4735 Application Number . . . . . 18-00000108 Date 1/25/18 Application pin number . . . 660460 Property Address . . . . . . 201 W 1ST ST ASSESSOR PARCEL NUMBER: 06 -30 -00 -0 -0 -1480 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Doer access and security ----------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ TINE CONSTRUCTION SERVICE LLC STANLEY SECURITY PMB 507 6161 E. 75TH STREET SAMMAMISH WA 980757253 INDIANAPOLIS IN 46227 (317) 806-3749 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . DOUBLE FEE, WORK W/OUT PERMT Permit Fee . . . . 372.00 Plan Chick Fee .00 Issue Date . . . . 1/25/18 valuation 0 Expiration Date . . 7/24/18 Qty Unit Charge Per Extension BASE FEE 186.00 1.00 96.0000 BCH EL -LIMITED 1ST 1500 SQ FT 96.00 18.00 5.0000 ECH EL-ADDNT LIMITED 1500 SQ FT 90.00 -------------------------- - ------- ----------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 372.00 372.00 .00 .00 Plan Check Total 00 .00 .00 .00 Grand Total 372.00 372.00 .00 .00 REPORT STATE SALES TAX on your excise tax farm. to the City of Part Angeles (Location Code 0502) iNSPECTION.TYPE DATE: RESULTS: fes.. INSPECTOR: I DITCH SERVICE ROUGH -IN FINAL COMMENTS: r PERMIT WILL EXPIRE SIX (6} MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 321 East Fifth Street — P.O. Bog 1150 / Port Angeles Washington, 98362 Ph: (360) 417-4735 Fag: (360) 417-4711 Date: 1/8/2018 x Multi -Family or Commercial* * Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: 201 West 1st ST Building Square Footage: 27,814 Description of above 2 story office building Owner Information Name: Tine Construction Service LLC Mailing Address: Po Box 1235 City: Maple Valley State: WA Zip: 98038 Phone: Fax: License # / Exp. Item 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 Sign/Outline Lighting Signal Circuit/ Limited Energy — Multi -Family Signal Circuit/ Limited Energy / First 1500 sf— Commercial Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5KVA System or Less Thermostat Note: $5.00 for each additional T-Stat Unit Charqe $132.00 $160.00 $ 225.00 $ 288.00 $ 410.00 $ 5.00 $ 74.00 $ 5.00 $ 86.00 $102.00 $121.00 $164.00 $185.00 $ 96.00 $ 88.00 $ 64.00 $ 96.00 $113.00 $ 56.00 pORTg1R, Contractor Information Name: STANLEY CSS Mailing Address: 2700 RICHARDS ROAD, SUITE 202 City: BELLEVUE State: WA Zip: 98005 Phone: 425-957-7026 Fax: License#/Exp. STANLCS925MZ -1 v I! Total (Qty Multiplied by Unit Charge) $ $ ^ $ 186.00 � I� $ tJot�K W l'ft-L 4V $ 186.00 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 296466, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, ele rical contractor or electrical administrator: X / Dated: 1/25/18 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 18-00000108 Date 1/25/18 Application pin number . . . 660450 Property Address . . . . . . 201 W 1ST ST ASSESSOR PARCEL NUMBER: 06 -30 -00 -0 -0 -1480 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Door access and security ---------------------------------------------------------------------------- Owner Contractor TINE CONSTRUCTION SERVICE LLC STANLEY SECURITY PMB 507 6161 E. 75TH STREET SAMMAMISH WA 980757253 INDIANAPOLIS IN 46227 (317) 806-3749 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . DOUBLE FEE, WORK W/OUT PERMT Permit Fee . . . . 372.00 Plan Chdck Fee .00 Issue Date . . . . 1/25/18 Valuation . . . . 0 Expiration Date . . 7/24/18 Qty Unit Charge Per Extension BASE FEE 186.00 1.00 96.0000 ECH EL -LIMITED IST 1500 SQ FT 96.00 18.00 5.0000 ECH EL-ADDNT LIMITED 1500 SQ.FT 90.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- Permit Fee Total ---------- ---------- 372.00 ---------- ----------- 372.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 372.00 372.00 .00 .00 INSPECTION TYPE DATE: RESULTS: DITCH SERVICE ROUGH -IN FINAL COMMENTS: PI Fr WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X REPORT STATE SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) k INSPECTOR M Date: Application Number . . . . . 22-00000903 Date 7/20/22 Application pin number . . . 386609 Property Address . . . . . . 201 W 1ST ST ASSESSOR PARCEL NUMBER: 06-30-00-0-0-1480-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Fire alarm ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ TINE CONSTRUCTION SERVICE LLC BOB'S ELECTRIC INC PMB 507 2293 DEER PARK RD. SAMMAMISH WA 980757253 PORT ANGELES WA 98362 (360) 457-6887 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee . . . . 181.00 Plan Check Fee . . .00 Issue Date . . . . 7/20/22 Valuation . . . . 0 Expiration Date . . 1/16/23 Qty Unit Charge Per Extension 1.00 96.0000 ECH EL-LIMITED 1ST 1500 SQ FT 96.00 17.00 5.0000 ECH EL-ADDNT LIMITED 1500 SQ FT 85.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 181.00 181.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 181.00 181.00 .00 .00 MUL,IT:FAM I LY I COM MERC rAI_ ELECTRI CAL PE RM IT APALI fi#[IgN Public Wbrks and Utilitics Departrnent 321 E. 5th Street, Port Angeles, lVA 98362 3S*".4 I7.4735 i -o tD.t 3 tf wwlry. c i tyo fpa. us I e lectri ca I perm i ts@c iryofpa. us + -frrel, tWr{wr.)*; *tu}* n Name: Mailing Address: Name: Mailing $ddress:&,e-ga- Ernail: 3,)*>>'?. lbrn $ervi*lFeeder m0 Amp. $ervie/Feeder 2A1 4W Amp. Service/Feeder 401 €00 Amp. ServicelFeeder 50 1 -1 Offi Arnp. Serulcet'Feeder over 10frI Arnp. Branch Circuit tt1/1 Servi* Feder Brancfr Cirwit WIO Service Feeder Each A#itiAnal Branch Circruit Branch Cimrits 1-4 Temp. $ervie/Feeder 200 Arnp. Temp Seruice/Feeder 201-40O Amp- Temp. ServicefFeeder 401€00 Amp. Ternp. SwielFeder S01 *1 m0 Amp. Portal to Portal Hourly $ignal Circ.ritflimited Energy - Multifamily Signal Cirmitrtimited Energy/Fimt 15ffi sf - Comnrercial (Note: $5"00 for each additional 1500 sf) Rene!ffabh Ehc. Energy: St(l/A $ystem or hs Thermoskt (Note: $5 fur each atlditional) Qua*Ji*r $ *-J"i'1.?,..-.* , rorAr- Owner as defined by RCW19.28.261: (1) Ownerwll occupy the sfucturre fortno years afterthh electrical pennit is ftnalized. (2) Orneris requircd b hire an eledricel cofltrac{or if above said property is fur sale, rent or lease. Permit expires afier six moflths of last inspestion. Afier reading the above stiatement, I hereby ceriify that I am ifie orner of the above narned propefi or a licensed elec'trical contractor. I am making the electrical installation oralteration in compliance with the elec'trical laws, N.E.C., RCW. Chapbr 19.28, WAC. Chapiar296- tlnit Sharge $132.00 $160.00 $225,00 $288.00 $410.00 $5^00 $74.00 $5.00 $ffi.00 $102.00 $121.00 $144.00 $185.m $e6.00 $88,0S $e6.00 $113.00 $s6.00 Total {AffirfiU x Unit Charga} $_ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 468,/The City of PortAngeles Municipal Code, and utility Specifications and PAMC 14.05.050 rgarding Electrical Permit Applications.*sli,rl zt {'treu A}0, i lo+*, G,Jy.{ Print Signature (f]Electrical *ontractor / Administrator) gt h,?f)- lsl .f*rel, lElectrical PermitApplications may be submitted to Cig Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711] Projec't Descriptian: d ,X..Jv'* r*. fi r*rd't ,f ;u*' J. i.$t ,ft"4 {}' ,ir"- PREPARED 7/19/22, 7:14:11 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:22-00000903 201 W 1ST ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL ALTER COMMERCIAL 181.00 TOTAL DUE 181.00 Please present reciept to the cashier with full payment ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: Partial ceiling and wall cover 1st & 2nd Floor Remaining inspection duct detectors and elevator. NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 7/25/2022 22-903 TAP OWNER CONTRACTOR Bob’s Electric PROJECT ADDRESS 201 W 1st St ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: Fire alarm NEC 760.41 The fire alarm circuit disconnect shall be permitted to be secured in the “on” position. NEC 300.21 Fire stop required in electrical room. NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 9/1/2022 22-903 TAP OWNER CONTRACTOR Bob’s Electric PROJECT ADDRESS 201 W 1st St ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: Fire alarm NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 10/3/2022 22-903 TAP OWNER CONTRACTOR Bob’s Electric PROJECT ADDRESS 201 W 1st St Application Number . . . . . 23-00000991 Date 9/18/23 Application pin number . . . 161823 Property Address . . . . . . 201 W 1ST ST ASSESSOR PARCEL NUMBER: 06-30-00-0-0-1480-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Fire alarm wireless ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ DEPARTMENT OF SOCIAL & HEALTH FIRE PROTECTION INC 201 W 1ST ST PO BOX 12642 PORT ANGELES WA 98362 MILLCREEK WA 98082 (360) 485-8112 (425) 290-9600 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee . . . . 96.00 Plan Check Fee . . .00 Issue Date . . . . 9/18/23 Valuation . . . . 0 Expiration Date . . 3/16/24 Qty Unit Charge Per Extension 1.00 96.0000 ECH EL-LIMITED 1ST 1500 SQ FT 96.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 96.00 96.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 96.00 96.00 .00 .00 MULTI-FA MILY/ COMMERCIAL ELE CTRICAL PERMIT APPL ICATION Public \Yorks and Utilities Department 321 E. 5th Street, Port Angeles. WA 98362 360.417.4735 I www.cityofpa.us I electricalpermits(s/.cityofpa.us Project Address:-------------------------------------- Project Description:--------------------------------------□Multi-Family Residential D Commercial I Industrial/ Public Building Square footage: __________ _ OWNER INFORMATION Name: ________________________ Email: ______________ _ Mailing Address: ________________________ Phone: ___________ _ ELECTRICAL CONTRACTOR INFORMATION Name: License: ___________ _ Mailing Address: ________________________ Expiration Date: ________ _ Email: Phone: ___________ _ PROJECT DETAILS llim! 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 Sign / Outline Lighting Signal Circuit/Limited Energy -Multi-Family Signal Circuit/Limited Energy/First 1500 sf -Commercial (Note: $5.00 for each additional 1500 sf) Renewable Elec. Energy: 5KVA System or less Thermostat (Note: $5 for each additional) Unit Charge Quantity $132.00 $160.00 $225.00 $288.00 $410.00 $5.00 $74.00 $5.00 $86.00 $102.00 $121.00 $164.00 $185.00 $96.00 $88.00 $88.00 $96.00 $113.00 $56.00 Total (Quantity x Unit Charge) $ ____ _ $ ____ _$ ____ _$ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _$ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ _____ 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- 46B, 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] lJ CD ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS Seal all unused openings ( ½ KO seal). NEC 110.12 NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 11/1/2023 23-991 TAP OWNER CONTRACTOR Fire Protection PROJECT ADDRESS 201 W 1st St ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 11/16/2023 23-991 TAP OWNER CONTRACTOR Fire Protection PROJECT ADDRESS 201 W 1st St Application Number . . . . . 25-00001267 Date 10/09/25 Application pin number . . . 406743 Property Address . . . . . . 203 W 1ST ST ASSESSOR PARCEL NUMBER: 06-30-00-0-0-1480-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . UNKNOWN Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Panic buttons ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ DEPARTMENT OF SOCIAL & HEALTH EVERON LLC 201 W 1ST ST 1501 W YAMATO RD PORT ANGELES WA 98362 BOCA RATON FL 33431 (360) 485-8112 (213) 392-9333 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee . . . . 235.00 Plan Check Fee . . .00 Issue Date . . . . 10/09/25 Valuation . . . . 0 Expiration Date . . 4/07/26 Qty Unit Charge Per Extension 1.00 190.2000 ECH EL-LIMITED 1ST 1500 SQ FT 190.20 8.00 5.6000 ECH EL-ADDNT LIMITED 1500 SQ FT 44.80 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 235.00 235.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 235.00 235.00 .00 .00 Public Works and Utilities Department 321 E. 5th Street, Port Angeles, WA 98362 360.417.4735 | www.cityofpa.us | electricalpermits@cityofpa.us ELCOM MULTI-FAMILY / COMMERCIAL ELECTRICAL PERMIT APPLICATION Project Address: Project Description: OWNER INFORMATION Name: Email: Mailing Address: Phone: ELECTRICAL CONTRACTOR INFORMATION Name: License: Mailing Address: Expiration Date: Email: Phone: PROJECT DETAILS Unit Charge Quantity Total (Quantity x Unit Charge) $237.75 $ $265.75 $ $332.85 $ $427.95 $ $523.05 $ $5.30 $ $95.10 $ $5.30 $ $95.10 $ $190.20 $ $237.75 $ $285.30 $ $332.85 $ $95.10 $ $142.65 $ $190.20 $ $190.20 $ $190.20 $ Item 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 Sign / Outline Lighting Signal Circuit/Limited Energy - Multi-Family Signal Circuit/Limited Energy/First 1500 sf - Commercial (Note: $5.60 for each additional 1500 sf) Renewable Elec. Energy: 5KVA System or less Thermostat (Note: $5.60 for each additional)$95.10 $ $ 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- 46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Date Print Name Signature (□Owner □Electrical Contractor / Administrator) Pe r m i t # : [Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417.4711] 201 W 1st. St WA DSHS-300927389 □Multi-Family Residential □ Commercial / Industrial / Public Building Square footage:12,955 SQ FT WA DSHS nwcommpermits@everonsolutions.com PO Box 45340 Olympia,WA 98504 360-485-8112 Everon LLC EVEROL*752CM 600 Oakesdale Ave SW Suite 100 2/14/2027 nwcommpermits@everonsolutions.com 425-464-3170 9 235.00 235.00 10/8/2025 Joyce Aquino Installation Work Packet Sales Agreement No. 892187464 Print Date: 10/7/2025 3:38:06 PM Customer Name: DSHS Address:201 W 1ST ST PORT ANGELES, WA 98362 Customer No: 40198939 Site No: 300100416 Job No: 300927389 Approval Number Associate: Paul Workland Phone: 360-350-8654 Contact Name: Contact Phone: 360-485-8112 Contact Cell: System Type: Intrusion System Design Name: PA Panic Buttons Sales Channel: Enterprise Solutions - Commercial Job Type: POC - Percentage of Completion CS Number: MASterMind Job Number: 300927389 Est. Start Date: Est. End Date: Contact List Name Phone Number Email Title Page 1 of 3 Tech Initials: __________ Equipment List (Estimate) Manufacturer Model Description Part Number QTY Bosch B820 INTERFACE MODULE GV4 TO INOVON ics EN4200 Receiver 1 Contractor/External Services (Estimate) Contractor Name Description EverOn LV Permit External Scope of Work This agreement is to replace clients current panic buttons (9). These panic to be programmed for light activation. 1st floor panics activate 2nd floor lights and 2nd floor panics activate 1st floor lights. These new panics will be wireless, (5) will go to DSHS COS and (4) will go to DCYF. ** These panics are for internal activation only of client's notification lights, not for 911 dispatch. ** Everon to provide new receiver & repeater and (9) wireless panic button Clients' current system is using ITI wireless equipment now which is obsolete, and no replacements are available. Current buttons are able to activate lights. No replacement lights or power supplies are included; we will be using existing lights and power supplies. Reference use of NASPO ValuePoint Contract: #99SWC-NV23-16259 "Security & Fire Protection Services" In-House Additional Labor Hours (Estimate) Description Install & Program PM Travel Page 2 of 3 Tech Initials: __________ Inovonics EN1233S SINGLE BUTTON NECKLACE PENDANT 9 Bosch EN4200 INOVONICS SERIAL RECEIVER 1 Inovonics EN5040-T High Power Repeater with Transformer 1 eSecure/Total Connect Installer Checklist: 1. Have the customer retrieve their User/PW and verify their email address through the first "Welcome Email" that is sent after the install is completed. 2. Show customer how to login to eSecure/Total Connect on a computer and walk through how to use it. 3. Explain that the following "events" have already been set up and explain the benefits they provide to the user. (Armed Stay/Armed Away/Disarm/AC loss/AC Restore/System Low Battery/System Battery Restored) 4. Ask the user if there are any other events they would like to be set up while the technician is there. (Alarm not set by this time, Alarm goes off, etc.) 5. Walk through how to use the Keypad. 6. Download eSecure/Total Connect on a mobile device, login and demo. (If not available, give 1-866-776-3205 for assistance later.) Technician Name (Printed)Technician Name (Signature)Employee Number Branch Number Date Page 3 of 3 Tech Initials: __________ ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN / COVER SERVICE FINAL CORRECTIONS NEEDED: NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 11/20/2025 25-1267 TMC OWNER Department of Social & Health Contractor Everon LLC ADDRESS 201 W 1st St