HomeMy WebLinkAbout1021 Caroline Street - Building ELE,CMCAi PER V ►
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360 41'7-4735
Application Number . 20-00000942 Date aREMRT SALES TAX
Application pin number 107138 on OUI'eXClSe tax form
ASSESSORAddress . . 1021 CAROLINE ST your
PARCEL NUMBER: a6-30-00=5-3-0440-0000- to the City of Pat Angeles
Application type description ELECTRICAL ONLY
Subdivision Name : . . . . (LoCadon Code 0502)
Property Use . . , . . . .
Property Zoning . . . . . . . COMMERCIAL OFFICE
Application valuation 0
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Application desc
Ethernet and access control
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Owner Contractor
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Olympic Medical Center ANGELES COMMUNICATIONS INC.
939 CAROLINE ST 102 ROSS IN.
PORT ANGELES WA 983623901 PORT ANGELES, WA
PORT ANGELES WA 98362
(360) 457-4375
-----Permit . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc .
Permit Fee . . . . 101.00 Plan Check Fee .00
Issue Date 8/19/20 valuation . . 0
Expiration Date 2/15/21
Qty Unit Charge Per Extension
1100 96.0000 ECH EL-LIMITED 1ST 1500 SO FT 96.00
x.
1.00 5.0000 ECH EL-ADDNT LIMITED `1500 SO FT 5.00
Fee summary Charged Paid Credited Due
----------------- ----- - - - -
Permit Fee Total 101.00 101.00 .00 .00
Plan Check Total .00 00 .00 .00
Grand Total 101.00 101.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR-
DITCH
SERVICE
ROUGH-IN o
FINAL
CONDAENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
Q EXdIANGEBUILDING
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MULTI-FAMILY / COMMERCIAL -
ELECTRICAL PERMIT APPLICATION
i I wl� Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362 U�
360.417.4735 ' ww.cityofpa.us .w electricalpermits@cityofpa.us lip
(B-0
Project Address: 1021 Caroline St. Port Angeles, WA 98362 (Wound Care Clinic)
Project Description: Add and move ethernet wiring, install access control wiring in remodeled building
❑ Multi-Family Residential R1 Commercial/Industrial/Public Building Square footage: 3000
OWNER INFORMATION
Name: Olympic Medical Center Email: rgale@olympicmedical.org
Mailing Address: 939 Caroline St, Port Angeles,WA 98362 Phone: 3604177000
CONTRACTORELECTRICAL INFORMATION
Name: Angeles Communications Inc. License: 601386512
Mailing Address: 102 Ross Lane Port Angeles,WA 98363 Expiration Date: April 30,2021
Email: don@angelescommunications.com Phone: 3604574375
PROJECT
Item Unit Charge 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 $
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
(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 $
$ 101 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,WAG.Chapter 296-
46B,The City of Port Angeles Municipal Code,and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
18, 202o Donald Simpson Donald L. Simpson Digitally signed by Donald L.Simpson
Aug p p Date:2020.08.18 08:52:17-07'00'
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]