HomeMy WebLinkAbout939 Caroline St (31)ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
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Applica!ion Numlcer
ApplicaEion pin numbe!
Property Address
ASSESSOR PARCE! I.JUMBER:
Application Eype descriPlion
subdivi.sion Nane
Properly Use
Propertsy Zoning
AppLicatsion valuaEion
21- ooooo4 04 Datse
99L372
939 CAROLINE ST
o5 - 30- 00-1-0-3325 - 0000 -
EIJECTRICAI' ONI'Y
4/Os/21
PUBI,IC BUII.DINGS & PARKS
0
Appticalion desc
Ethernet
PUBIJIC I{OSPITAL DISTRICT #2
939 CARO],INE ST
PORT ANGELES WA 98362
l36o) 4t'1-71'1o
ANGEI,ES COMMUNICATIONS INC.
102 ROSS IJN.
IORT ANGEIJES, VIA
PORT ANGELES WA 98362
l36AJ 45t -4375
Permits
Additsional de6c
Permil Fee
Issue DaEe .
Expiration Daie
106.00
4/05/2L
10 / 02 /2t
ELECTRICAI, AI,TER COMMERC1AL
Plan Check Fee
valuaEion
.00
0
oty Unit Charge Per
1 . 00 96 .0000 Ecli
2 .00 5 . 0000 EcH
EL-L]MITED 1ST 15OO SQ ET
EI]-ADDNT L1MITED 15OO SQ FT
106
106
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION T\?E DATE RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN
FINAL
COMMENTS K)(
PERMIT WILL EXPIRE SIx (6) MONTHS FROM LAST INSPECTTON
Permit Fee ToLal
Plan check ToLaI
Grand Total
106.00
.00
105.00
00
00
00
00
00
00
00
o0
00
Signature ofowner or Electrical Contractor X
CIEXCHANGE\BUILDING
Extension
96,00
10. 00
::i:::: :1r: :::i:::i :::
Date:
tM U LTI-FAM I LY / COIU tVI E RC IAL
ELE TRI PERMIT APPLICATION
Public Works and Utilities Depafiaent
3: I E. 5th Street. Port Angeles. \l,A 98362
I 60.4 I 7.4 7l 5 ] *.rvr,r,.c it1,ofpa. Lrs elecrricalperm its@c ityofpa.u s
Project Address Olympic Medical Center 939 Caroline Port An geles, WA 98362 (access control Phase2)
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Item
Service/Feeder 200.Arip..
Service/Feeder 20 1-400 Amp.
Service/Feeder 401-600 Amp.
Service/Feeder 601-1OOO Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Servicti Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder!01-600 Amp.
Temp. Service/Feeder.60-1 -1 000 Amp
Portalto Portal Hourly -,.- r':''
Sign / Outline Lighting
Ouantity Total x'Uiit Charge)
$132.00
$160.00
$225.00
$288.00
$410.00
$5.00
s74 00
$5.00
$86.00
$102.00
$'121 .00
$164.00
$185.00
$96.00
$88.00
$88.00
$96.00
$113,00
$56.00
$
$
$
$
$
$
$
$
$
$
Signal Circuivlimited Energy - Multi-Family : tt....
Signal Circuit/Limrted Energy/First '1500 sf - Commercial
(Note: $5.00 for each additional 15OO s0
Renewable Elec. Energy: sKVA System oi-less
Thermostat (Note: $5 for each addit,onal)
106
$
$
$106 TOTAL
Owner as defined by RCW 19.28.261: (1) Owner will occupy the structure for tv/o years after this electrical permit is finalized. (2) Owner is
required to hire an electrical contractor if above said properiy 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-
468, The City of PortAngeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
301'1ar2021 Donald Si mpson Donald L. Simpson Digitally signed by Donald L. Simpson
Date: 202'l.03.31'14:'15:53 -07'00'
Date Print Name Signature (E Owner p Electrical Contractor / Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa. us or faxed to 360.417.47111
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Prolect Description Low voltage (ethernet) wiring for External lP Cameras
E Multi-Family Residential 0 Commercial / lndustrial / Public Building Square footage: UNKNOWN
Name: Olympic Medical Center (Proiect lvlqr Jason Francis) Email: ifrancis@otympjcmedical.orlr
lvlailing Address: 939 Caroline St. Port Angeles, WA 98362 phone: !99llfl9?l_
Name Angeles Communications lnc License: 601386512
lvlailing Address: '102 Ross Ln Port Angeles, WA98363 Expiration Date: 30April,2022
Email don@angelescommunications.com phqns 3604574375
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O\;Ii/AIER.INFc R IVIAT I O N
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