HomeMy WebLinkAbout939 CAROLINS' -ST - Building L PERMIT
Ct&!-ANGELES
366411-4735
Application Number . . . 19-00000018 Date 2/13/19
Application pin number` . . 462122; - REPORT'STATE`SALES TAX'
Property Address . . . . . 939 CAROLINE sT on r @XCI$e tax form
PARCEL MASER- 06-30-00'-1-0-3325-0000 �u
Application type description ELECTRICAL. ONLY to the City of Prat Angeles
SubProperty
Name
Pro (Location Code 0502)
perty Use. _ _
Property Zonis-, . . r PUBLIC BUILDING$ & PARKS
Application valuation . . . 0
- _ ---------------- ----- -- --- -
Application desc
Plan review surgery chiller
Owner 'Contractor
- --------- ---- ----- -
PUBLIC HOSPITAL DISTRICT #2 OWNER `
939 CAROLINE ST
PORT AMBLES WA 98162
(360) 417-7170
------------------------ ------------------------------- ----------------
Permit
--^'- ---------Permit • bLECTRICAL PLAN REVIEW
Additional dese
Permit Fee . . . 435.03 Plan Cheek Fee .00
Issue Date . . 1/04/19 Valuation . . 0
Expiration Date .
Qty Unit Charge Per : Extension
BASE FEE 435.03
.00 1.0000 BCH EL-PLAN REVIEW .00
------------------------ _`--------- _
---- - ^-•--------- ---- -
Fee summary Charged Paid Credited Due
_-__- •----- -------- - ---------
Permit Fee Total 435.03 435.03 .00 .00
Plan Check Total 00 .00 00 00
Grand Total 435.03 435.03 .00 .00
INSPECTIONTYTE. DATE: RESULTS: INSFECrOR.
DUCH
SERVICE
ROUGH-IN
FINAL
COMMENTS: -
PERMIT WILL OMME SIX(6)MONTHS FROM LAST INSPEC,MN
Signature of-owner or EYeotrieW Contractor X Date:
1/24/19 Invoice No. 19-18
To
Olympic Medical Center
Attn: Lee Swanson
939 Caroline Street
Port Angeles WA 98362
Electrical plan review final fee.
Surgery Chiller
Quantity Description Unit Price Total
2.25 BHC consultant fee 90/94.50 203.63
1 BHC Postage 27.13 27.13
1 City shipping FedEx ground 19.44 19.44
1 Labor City of Port Angles 97.65 97.65
1 Penprint copies 30.44 30.44
15%Administrative fee 56.74
Sub Total 435.03
Cost estimate deposit 500.00
Credit Total 64.97
Due upon receipt
Thank you for your business!
City of Port Angelesv�FpORTq^,�
Tel 360 417 4735 tpeppard@cityofpa.us
Fax 360 417 4711 '���
• ORTNGELES '
WASH 1 N�G T O N, U. S. A.
Public Works & Utilities Department
1/3/2019
Olympic Medical Center
Sazan Group
Attn: Lee Swanson
Pnq 939 Caroline St
Port Angeles WA 98362
Subject: Electrical Plan Review. Surgery Chiller
M
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Lee,
,
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�. The estimated cost for your electrical plan review is $500.00 this estimate is good for
n 180 days from the date of this letter. The City requires that you deposit an amount
equal to the estimate with the City as part of your permit application. The actual fee
N� - .�
will be the City's labor and material cost plus a 15% administrative fee.
If the actual cost exceeds the deposit amount, the City will bill you for the overage. If
� the actual cost is less than the deposit, the difference will be refunded.
94,
b
� .� �a If you have any questions or concerns,feel free to contact me at the phone number, or
e-mail, listed below.
-�Z
Sincerely, j
*-M-N,Mm
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x Trent Peppard
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Senior Electrical Inspector
tpeppard@citvofpa.us
� ��g -VWk 360 417 4735
arta
� Cell 360 808 2613
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Phone: 360-417-4800/Fax: 360-417-4542
q-N-p� Website: www.cityofpa.us/Email: publicworks@cityofpa.us
321 East Fifth Street/Port
-0217
Angeles, WA 98362
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