HomeMy WebLinkAbout240 W Front Street - Building 3
ELECTRICAL PERMIT ., 1
CITY OF PORT ANGELES
360-417-4735
Application Number 16-00001667 Date 11/07/16
Application pin number . . 033668
Property Address 240 1/2 W FRONT ST SLIGT REPORT.SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-1405-0000-
Application type description ELECTRICAL ONLY on your excise tax form
Subdivision Name
Property Use to the City of Port Angeles
Property Zoning UNKNOWN (Location Code 0502)
Application valuation . . . 0
•
Application desc •
Tree well Recept
Owner Contractor
OLYMPIC MEDICAL CENTER OWNER
240 W. FRONT ST., STE. A
PORT ANGELES WA 98362
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc 1-4 CIRCUITS
Permit Fee . . . 86.00 Plan Check Fee . . .00
Issue Date . . . 11/07/16 Valuation . . . . 0
Expiration Date . 5/06/17
Qty Unit Charge Per Extension
—BASE FEE 86.00
•
Fee summary Charged Paid Credited Due
,Permit Fee Total 86.00 86.00 .00 .00
;Plan Check Total .00 .00 .00 .00
Grand Total 86.00 86.00 .00 .00
•
INSPECTION TYPE DATE: RESULTS: INSPECTOR
DITCH
SERVICE
ROUGH-IN I[ 3i I l
FINAL
b)
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
Cr:\EXCHANGEIBUILDING
i
CITY OF PORT ANGELES PERMIT APPLICATION 1
Building Division/Electrical Inspections V
321 East Fifth Street—P.O.Box 1150/Port Angeles Washington,98362 ___
Ph: (360)417-4735 Fax: (360)417-4711
Date: /IN/6 r/ Multi-Family or Commercial*
*Plan Review May& uired, lease C ElectricalPlan Review Information Sheet
Job Address: Z-tO 1, ,
Building Square Footage:
Description of above /Q4,/ /QE.eAio-T._ 0A1 vtrw ,u 7-z i 141 �i!.es(,rJ .Ls ,
Owner Information Contractor Information
Name: t?Jry 07e /C1 AL 61_,t4,g Name:
Mailing Address` ,9.2I a 5' sr" Mailing Address:
City: V-Ai 6k,LI�State: c,,w4 Zip: ?$3 G. 7_ City: State: Zip:
Phone. 7 O jf Fax: M.
Phone: Fax:
License#/Exp. �io1-2v ,4t _ q7/Alb 1 -2_/-14. License#I Exp.
Item Unit Charge (2ty Total(Qty Multiplied 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 Circuit 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 1 $ 5- b !n'
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 $
Portal to Portal Hourly $ 96.00 $
Sign/Outline Lighting $ 88.00 $
Signal Circuit/Limited Energy—Multi-Family $ 64.00 $
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
$ 0 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.
Signature of owner,electrical contractor or electrical administrator: ❑ Cash 0 Check
�y
0 Credit Card#
X . M— C �—` Dated: /(-- / /4 0110112012