HomeMy WebLinkAbout2138 Bldg 1040 W 18th St (2)Application Nurnber
ApplicaEion pin nudber
Property Address
ASSESSOR PARCEI, NWBER:
Applicatsion ts}pe description
subdivision Name
Property Use
Proper.!y Zoning
ApplicaEion vaf\ration
ELECTRICAL PERMIT
CIry OF PORT ANGELES
360-417-4735
18 00001194 Dale -t /37/te
3'18152
2138 BLD6 1040 W 18Tll ST
0 6 - 3 0 - 0 0 - I - 1 - 210 0 5001
ELECTR]CAL ON],Y
INDUSTRIAL IJIGHT
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application desc
TV outlet and server room outleEs
Contractor
PORT OF PORT ANGELES
PO BOX 13 50
PORT ANGELES
(350) 457-8527
SIMPSON ELECTRIC
243035 I^l HWY 101
PORT ANGELES
136O) 45'7 92',7A
wA 983 6 202 51 wA 983 63
Addltional
Permit Fee
Is sue Date
desc
EI]ECTRICAI ALTER COMMERCIAIJ
14 CIRCUITS
86.00 Plan Check Fee
1/31/ ta valuat ion
t/27 /1,9ExpiraLion Date
Qty Unjt
00
a
Charge Per
BASE FEE
Extension
85.00
Charged Pa id Credited Due
Permit Eee Total
PIan Check Total
Grand Total
86.00
.00
86.00
86.00
.00
85 .00
00
00
00
00
00
00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST TNSPECTION
DATE:RESULTS:INSPECTOR:
DITCH
SER\'ICE
ROUGH-IN zlA ln €E"r
FINAL z'tril[n $y H!4)
COMMENTS:I
INSPECTION TYPE
Signature ofowner or Electrical Contractor X Date:
MU LTI-FAMILY i COMM ERCIAL
LECTRlCAL IT APPLICATI
Public \lbrks and {.ltilitics i)epartment
-31I I. 5th Stre.et. Pofl ,\ngeies. \1..\ 98-16l
-r(rO,.i. I 7--17-15 tr r\\\.cilr otpa.us electricalpc.nnits 4ciI\ oti)a.ns
frE0fiyEm
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Project Address. 2138 W 18th St PoIt Angeles, WA 98363
Project Desc{iption Circuits for TV Outlet, changing outlet in Server Room
E Muld-Family Residential E Commercial / lndustiat / public Buitding Square footage:
fr,hms; ACTI Email:
Name:Simpson Electric LLC License: SIMPSELgT3RQ
Expiration
phone: 36G457-9270
Mailing Address: PO Box '1086
Email:dlsimpson5l @gmail.com
ttem
Service/Feeder 200 Amp.
Service/Feeder 201 -2100 Amp.
Service/Feeder 401 4OO Amp-
Servicey'Feeder 501-1 0OO Amp-
SeMce/Feeder ove. 1000 Amp-
Branch Circuit W/ Se.vice Feeder
Branct Circuit WO Service Feeder
Each Additional Branch Cirolit
Branch Cirolits 1-4
Temp. Service/Feeder 20O Amp-
Temp. Service,/Feeder 201 400 Amp.
Temp. Service/Feeder 401 $00 Arnp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourty
Sign / Outline Lighting
Signal Circuiullmited Energy - Multi-Famity
Signal Circuiulimited Energy/Firsi I 500 sf - Comrnercial
(Note: $5.00 fo. each additional 15OO sf)
Renewable Elec. EneEy: SKVA System or less
Thermostat (Note: $5 for each additional)
Quantitv fg[! (Guantity x Unit Charge)
86.00 TOTAL
Urul Charoe
$132.00
$160.00
$225.00
$288.00
$410.m
$5.00
$74.00
$5.00
$86.00
s102.00
$121.0O
$164.00
$185.00
$95.00
$88.00
$88.00
$96.00
86.00
$
$
$
$
$
$
$
$
!
$
$
$
$
$
$
5
$
$
$
$
$113-00
$56_00
owner as defined by Rcw.19.28.261: (1) owner will occupy the structure for two yea.s afrer this electrical permit is finalized- (2) Owner is
rcquiaed tro hire an electrical contractor if above said property is for sale, rent or lease. Permit expiaes after six months of last inspection,
After reading the above statemen! I hereby ceftiry that I am the owner of the above narned property or a licensed electrjcal cont-actor. I
am making the electical irstallation or atteration in compliance with the electrical laws, N.E.C., RCW- Chapter 19.28, WAC. Chapter 296-468, The city ol Pod Angeles Municipal Code, and Utility Specifications and PAMC 14,05.050 regarding Electricat permit Applications-
7l3Ol2O18 Andrew P Simpson
Date Print Name Signature (Owner p / Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.41111
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OWNER INFORIMATION
Mailing Address: 2138 W 18th St Port Angeles, WA 98363 p66ns. Matt_ 360-477-3276
ELECTRICAL CONTRACTOR INFORMATION
Date.. 1211112019