HomeMy WebLinkAbout907 Georgiana St (4)Application Number
ApplicaEion pin number
Property Address
ASSESSOR PARCEL NUMBER I
Applicatsion type description
Subdivision Name ...
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Applicatj-on valuaEiotl . .
BLBCTRICAL PERMIT
CITY OF PORT ANGBLES
x60-417-4715
COMMERCIAI, OFFICE
0
19- 00000657 Date 5/01/L9
0 5 818:t
907 GEORGIANA ST
0 6 - 3 0 - 00 - 5 - 8 - 0145 - 0000-
EIJECIRICAII ONI]Y
REPORT STATE SALES TAX
on your exclse tax form
to the Clty of Port Angeles
(Locatlon Code 0502)
-_sIN\N
*t
Applj.cation desc
ElherneE wiring
Contractor
CITALLAM CO HOSPITAI DIST f2
939 CAROI,INE ST
PORT ANGET-ES WA 983623909
ANGEIES COMMUNTCATfONS ,INC .
102 ROSS LN.
PORT ANGELES, WA
PORT ANGELES TiA 98362
/'350) 457 -4315
PermiE
Additionaf desc
PermiE Fee
Issue Date
96.00
5/07/1-9
).r / 03 /19
ELECTRICAI- ALTER COMMERCIA!
Plan Check Pee
valuati.on
00
0Expiration Date
oty Unit Charge1.00 96.0000
PerECH EL-LIMITED 1ST 15OO SQ FT
Extensioa
95 .00
charged Paid CrediEed Due
PermiE Fee Total
PIao Check Totaf
Grard Totsa1
95 .00
.00
95.OO
96.00
.00
95 .00
00
0o
00
00
00
00
?tr8{m wEL EX?RE StX (5) t4$[ftrs FROrd IAST nlsp&TION
INSPBETIONTI'PE DATR RESUITST INSPECTOR:
DTTCg
SERVIEE
ROUGH=IN 5l rdv
FI}IAL 6 glt,1 *fl
C0{MENTST
IIIrI
Slgmtuc of ow or Eleoufual Oonurers,r Datc:
re h?l :+D
TVIULTI-FA MILY / COMMERCIAL
ELECTRICAL PER MIT APPLICATION
Public Works and Utilities Departrnent
321 E.5th Street. Port Angeles, \lA 98362
:i60.4 I 7.47i5 i *rrrv.cityofpa.us I clectricalpermits@cityofpa.us
l,o
3
f,ini;f :5
\
\\lProject Address 907 Geirgiana St. Port Angeles, WA 98362
Proiect Descript,on Elhernet wirinq in basement suite
E Multi-Family Residential E Commercial / lnduskial i Public Building Square footaqe:work area <1000sft
Name Olympic lvled ical Center
Mailing Address 939 Caroline St. Port Anqeles, WA 98362
Email
phone.360-417-7000
Name:Anqeles Communications License:601386512
Expi ration Date: 4l3Ol202OMallingAddress. 102 Ross Ln Port Anaeles, WA 98363
Email:don@angelescommunications.com Phone 3604574375
Item
ServicdFeeder 200Amp.
Service/Feeder 20140O Amp.
Service/Feeder 40 1600 Amp.
Service/Feeder 60'l -1 0O0 Arnp.
Servic€/Feeder over 1 000 Amp,
Branch Cirq.Jit W SeNice Feeder
Branch Cirojit WO Servie Feeder
Each Additional Branch Circuit
Branch CireJits 1-4
Temp. ServicdFeeder 200 Amp.
Temp. ServicdFeeder 20'l-400 Amp_
Temp. ServicdFeeder 401-600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Sagn / Outline Lighting
Signal CircuiuLimited Energy - Multi-Family
Signal CircuivLimited Energy/First 1500 sf - Commarcial
(Note: $5.00 for each additional 1500 6D
Renewable Elec. Energy: sl(VA SystBm or less
Thermostat (Note: $5 tor each additional)
unlt Cherge
$132.00
$ 160.00
$225.00
$288.00
$410.00
s5.00
$74.00
$5.00
$86.00
$102.00
$121.00
$164.00
$'185.00
$96.00
$88.00
s88.00
$96.00
Quantity fOlAl (Quantity x Unit Charge)
$
$
$
$
$
I
$
$
$
$
$
$
$
s
$
$
96Y
$113.00
556.00
96 TOTAL
Ovv'ler 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 it 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 electri N,E.C,, R pter 19.28, WAC. Chapter 29&
468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 05.0 ing Electrical Permit Applications.
May 6, 2019 Donald L. Simpson
Print Name Signature (E OwnerF Electrical Contractor /inistratori
IElectrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.47111
OWNER INFORMATION
ffitrE .L CONT.RACTOR INFORMATION
Date