HomeMy WebLinkAbout939 Caroline St (32)ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -4735
PUBLIC BUILDINGS & PARKS
0
REPORT STATE SALES IAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application Nunrber
Applicatsion pin number
Property Address
ASSESSOR PAACEI NOMBER :
Application t,'pe descriptsion
Subdivision Name
Property Use
Pr.operty zoning
AppfiiaEion valuatsion
21-00000565 Date 6/a3/21
1753C5
93 9 CAROLINE ST
06-3C 00 1 0 l l25 00c0,
EI,ECTRiCA]- ONLY
Application desc
Chair li fL EP. #1
PIIBLIC HOSPfTA! DISTRICT +2
93 9 CAROLINE ST
PORT ANGELES WA 98362
(350) 417 7170
OLYMPIC ELECTRIC CO lNC
423 O TUMWATER
PORT ANGELES WA 9836]
(360) 4s7-s303
PermiE
Additional desc
Permits Fee
Issue Date
Expiration Date
74 .04
E /03 /2t
lt /30 / 2t
EI,ECTRICAL AITER COMMERCIAI,
00
0
Qty UniL Charge Per
1.00 74.0000 ECH Er-coMM BR-ANCII CrR WO/ S/F
ExEension
14.04
Charged Paid Credited Due
Permit Fee ToLal
Plao Check Total
Grand Totdl
'74.04
.00
74 .04
00
o0
00
00
00
00
iNSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
ROUGH-IN
FINAL
COMMENTS ry
PERMIT WILL EXPTRE SIX (6) MONTHS FROM LAST TNSPECTION
Signa ture of owner or Electrical Contractor X
Plan Check Fee
vafuaEioa
74 .00
.00
74 .00
SERVICE
Date:
IVIULTI-FAIM ILY / COMMER C AL
ELECTRI CA L PERMITAPPLICATION
Putrlic Works and Utilities Department
3:1 E. -sth Srreer. Po Angeles, \!A 98-162
364.4 17.47 35 | wulr,.cityofpa.us I elecricalperrnits@cityotjra.us
1'o
3
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Project Address 939 CAROLINE ST
Project Descrip s;on. ADD OUTLET FOR CHAIR LIFT lN ER ROOTM #1
E Multi-Family Residential 0 Commercial / lndustrial / public Building Square footage
OWNER INFORMATION
Name: OLYMPIC MEDICAL CENTER Email
360-460-1284
ELECTRICAL CONTRACTOR INFORMATION
Name Olympic Electric Co ,lnc.fissn5s OLYMPEC285D1
Mailing Address: 4230 Tumwater Truck Route _ Expiration Date o313112023
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401-600 Amp
Service/Feeder 60'1 -'1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch C rcuit 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 401-600 Amp.
Temp. Service/Feeder 601-1000 Amp
Portal to Portal Hourly
Sign / Outline Lighting
Signal CircuiULlmited Energy - Multi-Family
Signal CircuiVLimited Energy/First 1500 sf - Commercial
(Note: 95.00 for each additionat 1500 sf)
Renewable Elec. Energy: 5KVA System or less
Thelmostal (Nore $5 for each additionat)
Unit Charoe Ouantity Lelal (Quantity x Unit Charge)
$132.00
$160.00
$225.00
$288.00
$410.00
$s.00
$74 00
$5.00
$86.00
$102.00
$121.00
$164.00
$185.00
$96.00
$88.00
$88.00
$96.00
74.OO
$
$
$
$
$
$
$
$
$
$
$
$
$
s
$
$
$
$
$
$
$113.00
$56.00
74.O TOTAL
Owner as defined by RCW 19.28.26'1: ('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-
468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical permit Applications.
0610112021 Michael L. Rutten lVichael L. Rutten
Date Print Name Signature (F Owner p Electrical Contractor / Adminiskator)
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa. us or faxed lo 360.41Z.all1]
Mailing Address: 939 CAROLINE ST. PORT ANGELES, WA.98363 phone.
Email maureenm@olympicelectric.net pfiene; 360_457-5!g3
PROJECT DETAILS
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