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ELECTRICAL PERMIT ;
CITY OF PORT ANGELES
360-417-4733
CIA
Application Number . . . . 20-00001314 Date 11/13/20
Application pin number . . . 669114
Property Address 1133;E PARK AVE
ASSESSOR PARCEL NUMBER:` 06>30-11-5-1-0800-0000
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . .
Property Zoning . . . . . . . RESIDENTIAL MEDIUM DENSTY
Application valuation . . . . 0
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Application desc
Building remodel
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Owner Contractor
LAUREL PARK AID PROPCO LLC C M G ELECTRIC LLC
C/O ASSISTED LIVING CONCEPTS 31448 55TH AVE S
330 N WABASH AVE SUITE 3700 AUBURN WA 98001
CHICAGO IL 60611 (253) 335-2103 J
(312) 725-7020
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Permit . . . ELECTRICAL ALTER COMMERCIAL
Additional desc .
Permit Fee . . . . 404.00 Plan Check Fee .00
Issue Date . . . . 11/13/20 Valuation . . . . 0
Expiration Date . . 5/12/21
Qty Unit Charge Per Extension
28.00 5.0000 ECH EL=BRANCH CIRCUIT W/FEEDER 140.00
2.00 132.0000 ECH EL-COM 0-200 SRV FEEDER 264.00
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Fee summary Charged -Paid- -Credited- Due
Permit Fee Total 404.00 404.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 404.00 404.00 .00 .00
i
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH,IN a 3
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTIQN
Signature of owner or Electrical Contractor X Date:
GAEXCHANGE\BUILDING
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MULTI-FAMILY / COMMERCIAL
ELECTRICAL PERMIT APPLICATION 3
Public N brk.s and Utilities Department
321 1 . 5th Street, Port Angeles, WA 98362 �
360.417.4735 1 wtiv",.cityofpa.us 1 electricalpermits�cityofpa.us
Project Address: 1133 E PARK AVE PORT ANGELES, WA 98362
Project Description: PARTIAL BUILDING REMODEL; UPGRADE ONE PANELBOARD
❑ Multi-Family Residential R) Commercial/Industrial/Public Building Square footage: 32,318
OWNER INFORMATION
Name: IHC LAUREL PLACE LLC Email: b6an@ihcfunds.com
Mailing Address: 8502 E PRINCESS DR STE 200 SCOTTSDALE,AZ 85255 ` Phone: 602-570-4966
ELECTRICAL CONTRACTOR INFORMATION
Name: CMG Electric LLC License: CMGELMG941QG
Mailing Address: 31448 55th Ave S Auburn,WA 98001 Expiration Date: 11/7/2022
Email: gerstner_c@msn.com Phone: 253-335-2103
■ .O D A
&M Ugit Charge Quantity Total(Quantity x Unit Charge)
Service/Feeder 200 Amp. $13200 2 $ 26400
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 24 $ 120.00
Branch Circuits 1-4 $86.00 1 $ 86.00
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. $18500 $
Portal to Portal Hourly $96.00 $
Sign/Outline Lighting $88.00 $
Signal Circuit/Limited Energy-Multi-Family $88.00 $
Signal Circuit/Limited Energy/First 1500 sf-Commercial $96.00 $
(Note: $5.00 for each additional 1500 so
Renewable Elec. Energy: 5KVA System or less $11300 $
Thermostat(Note: $5 for each additional) $56.00 $ ���,
$_ TOTAL 'lD j
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.
10/16/2020 Casey Gerstner Casey Gerstner Digitally signed by Casey Gerstner
Date:2020.10.16 14:40:22-07'00'
Date Print Name Signature([] Owner V Electrical Contractor/Administrator)
(Electrical Permit Applications maybe submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]
ELE `PERmrr a
CITY OF kT ANGELES
60-41 T-4'735
11p1ication Number . 20-00000279' Date 3/02/20
Application pin number 670022 REPORT STATE SALES TAX
Propery Address 113 $ PARK PARK-AVE on our excise tax form
ASSESSOR PARCEL NUMBER: 06-30-11-5-1-0800.0000- Y
Application type description ELECTRICAL ONLY ' to the City of Port Angeles
Subdivision Name . . . . (Loceflon Code 0502)
Property Use . . . . .
Property Zoning RESIDENTIAL MEDIUM DENSTY
Application valuation . 0
- ---- ------ ---- ------
Application desc
Egress doors, adding REX motion det.
Owner Contractor
------------------------
LAUREL PARR AID PROPCO LLC WESTERN STATES FIRE PRTCTN CO
C/O ASSISTED LIVING CONCEPTS 14690-NE 95TH ST STE 101
330 N WABASH AVE SUITE 3700 REDMOND WA 98052
CHICAGO IL 60611. (425)'881-0100
(312) 725-7020
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Permit . . . . .. ELECTRICAL ALTER'COMMERCIAL'
Additional desc
Permit Fee . . 96.00 Plan Check Fee .00
;.Issue Date _ ., 3/02/20 Valuation;- 0
Expiration Date 8/29/20
Qty Unit Charge Per Extension
1.00 96.0000 ECH EL-LIMITED 1ST 1500 SQ FT 96.00
------ --- --- ---- --- ------------------ ----- ---------- -
Fee summary Charged ---Paid Credited Due 4
- --------------- =-------- --- ---------- --------- I
Permit Fee Total 96.00 96.00 .00 .00 #
Plan Check Total -.00 .00 .00 .00
Grand Total 96.00 96.00 .00 .00
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INSPECTION TYPE DATE: RESULTS: INSPECTOR:
i
DITCH
SERVICE
i
ROUGH-IN
i
FINAL
COMMENTS:
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PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPSMON
Signature of owner or Electrical Contractor X Date:
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MULTI-FAMILY / COMMERCIAL
ELECTRICAL PERMIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port.Angeles, WA 98362
360.417.4735 1 wNN,-w,cityofpa.us electricalpennits(rLcityofpa.us
Project Address: 1133 E Park Ave
Project Description: Changing the setup for egress doors and adding a REX motion detector to it.
El Multi-Family Residential 0 Commercial/ Industrial/Public Building Square footage: 1500
OWNER INFORMATION
Name: Laurel Park Aid Propco LLC Email:
Mailing Address: 330 N Wabash Ave STE 3700,Chicago,IL Phone:
F
ELECTRICAL CONTRACTOR INFORMATION 6
Name: Western States Fire Protection License: WESTESF906PI
Mailing Address: 14690 NE 95th St#101, Redmond,WA 98052 Expiration Date: 11/9/2020
Email: Seth.Zehnder@wsfp,.,,US, Phone: 425-478-9709
PROJECT DETAILS
bm Unit Charge Quantity IqW(Quantity x Unit Charge)
Service/Feeder 200 Amp. $132.00 $
Service/Feeder 201400 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 $
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 $88.00 $
Signal Circuit/Limited Energy/First 1500 sf-Commercial- $96.00 1 $ 96.00
(Note:$5.00 for each additional 1500 sf)
Renewable Elec.Energy:5KVA System or less $113.00 $
Thermostat(Note:$5 for each additional) $56.00 $
$ 96.00 TOTAL
Owner as defined byRCW.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.
Dlgjially FIpod by Seth Zehnder
'C=US,E=seth.zehnder@wsfp.us,O=Western
"State Fire Protection,CN=Seth Zehnder
2/27/2020 Seth Zehnder Seth Zehnderl"...,,;s202,.,,.2710:25,,4-0,,00.
Date Print Name Signature(E] Owner V Electrical Contractor/Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]