HomeMy WebLinkAbout939 Caroline St (4)Application Nulnber
Application pin number
Property Address
ASSESSOR PARCEIJ NUMBER:
Applicatsion ty!,e descriptioo
Subdivision Name .
Property Use
P::operty Zoning
Application valuation
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4t7-4735
PUBIIC BUILDINGS & PARKS
0
18 - 00001912 Dare 2/t3/19
529200
939 CAROLINE ST
05 - 3 0 - 00 - 1- 0 - 332 5 - 0000-
ETECTRTCAJ] ONI,Y
REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Applicatsion desc
PIan revien Cent.ral Sterile process
Onmer Contractor
PUBI,IC HOSPITAL DISTRICT S2
939 CAROLINE ST
PORT ANGELES WA 98362
{350) 41?-7170
OWNER
Permit
Addilional desc
PermiE Eee
Issue Date
ExpiraLion Date
ELECTRICAL PIAN REVIEIT
PI"AN REVIEW FEE BALANCE
625.97 Plan Check Fee
L2 / 19 /r8 Valua!ion
o0
0
Qty unit
s00 .00
Extension
12s.97
500.00
charge Per
1.0000 ECH
BASE T'EE
EL-PLAN REVIEW
Fee summary Charged Paid CrediEed Due
Permil Fee Total
Plan Check Tolal
Grand ?oEa1
625 .9 7
.00
525.97
625 .91
.00
625.97
.00
.00
.00
.00
.00
,00
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN
FINAL zlolm $r
COMMENTS
III
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST TNSPECTION
Signature ofowner or Electrical Contractor X Date
-str
1124t19 Invoice No. 18-1912
To
Olympic Medical Center
Attn: Lee Swanson
939 Caroline Street
Port Angeles WA 98362
Electrical plan review flnalfee
Central Sterile Processing
City of Port Angeles
Due upon receipt
Thank you for your businessl
Quantity Description Unit Price Total
J.C BHC consultant fee 90/94.50 315.00
BHC Postage 27 .32 27 .32
1 City shipping FedEx ground '18.75 '18.75
Labor City of Port Angles 97.65 97.65
1 Penprint copies 85.60 85.60
1 5% Administrative fee 81 .65
Sub Total
Cost estimate deposit 500.00
Balance Total 125.97
tpeppard@cityofpa.us
C()ttI
Tel360 417 4735
Fa\ 360 417 4711
1
1
625.97