HomeMy WebLinkAbout939 Caroline ST - Building (3) t
77
ELECTRICAL PERMIT
CITY OF PORT ANGELES
36"17-4735
Application Number . . . . . 21-00000793 Date 6/29/21
Application pin number . , . 892172
Property Address 939 CAROLINE ST
ASSESSOR PARCEL NUMBER: 06-30-00-1-0-3325-0000-
Application type description ELECTRICAL ONLY
Subdivision Name .
Property Use . . . . .
Property Zoning . . . . . . PUBLIC BUILDINGS & PARKS
Application valuation . . . 0
- - - - - -
Application desc
Load bank
----------------------------------------------------------------------------
Owner Contractor
PUBLIC HOSPITAL DISTRICT 3#2 LEGACY TELECOMMUNICATIONS INC
939 CAR.OLINE ST PO BOX 360
PORT ANGELES WA 98362 BURLEY WA 98322
(360) 417-7170 (253) $58-0214
----------------------------------------------------------------------------
Permit . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc . .
Permit Fee . . . . 513.00 Plan Check Fee .00
Issue Date . . . . 6/29/21 valuation . . . 0
Expiration Date 12/26/21
Oty Unit Charge Per Extension
2.00 164.0000 BCH EL- COMM 401-600 TEMP SRV/F'DR 328.00
1.00 185.0000 ECH EL- COMM'601-UP TEMP SRV/FDR 185_00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
'Permit Fee Total 513.00 513.00 .00 .00
Plan Check Total 00 .00 .00 .00
Grand Total 513.00 513.00 .00 .00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
i
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
ti
SERVICE
ROUQH-IN
FINAL
COMMENTS:
PERMIT WELL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
GAEXCHANWBtIILDING
As wt& ,
ry
e
MULTI-FAMILY / COMMERCIAL
ELECTRICAL PERMIT APPLICATION 3
I�lublic NVorks and Utilities Department
321 E. 51:h Strect, Port Angeles. l ',A,98.362 1
360,417.4735 1 www.cityofpa.us electi-icalpern-iits'�x,,citvofl-)a.iis C��
V�
Project Address: 939 Caroline St Port Angeles, WA 98362
Project Description: OMC Load Banks- 3 generators
0 Multi-Family Residential EKI Commercial/Industrial/Public Building Square footage:
OWNER
• ' •
Name: Olympic Medical Center Email
Mailing Address: 93 Caroline St Phone: 360-417-1621
Name: Legacy Power Systems License: LEGACTL821 LJ
Mailing Address: 8102 Skansie Ave Gig Harbor WA 98332 Expiration Date: 06-14-2022
Email: thomas.dunham@legacypower.com Phone: 253-858-0214
PROJECTDETAILS
ltga Unit Charae Quantity Total(Quantity x 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 $
Temp. Service/Feeder 200 Amp. $102.00 $
Temp. Service/Feeder 201-400 Amp. $121.00 $
Temp. Service/Feeder 401-600 Amp. $164.00 2 $ 328.00
Temp. Service/Feeder 601-1000 Amp. $185.00 1 $ 185.00
Portal to Portal Hourly $9600 $
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 $113.00 $
Thermostat(Note: $5 for each additional) $5600 $
a 5'13.00 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 296-
46B,The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
06/25/2021 Thomas Dunham
Date Print Name Signature(❑ Owner V Electrical Contractor/Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]