The URL can be used to link to this page

Home My WebLink About907 Georgiana St (5)ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417 -473s COMMERCIAI OFFICE 0 REPORT STATE SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) 3\ a\V Application Nuniber Applicatsion pin nurnber Propertsy Address ASSESSOR PARCEL NWBER: Application tlpe descripEion Subdivision'Name Property Use Property zoning Appl"ication valuaEion 19- 00000453 Date 4/02/\9 2t6437 907 CEORGIANA ST 06- 30-00- 5 - 8- 0l-45 - 0000 - ELECTRICAL ONLY Application desc Off ice space improvementss Colltractor CI,ALLAM CO HOSPITAL DIST #2 93 9 CAROLINE ST PORT ANGELES WA 983623909 STMPSON ELECTRIC 243035 W HWY 101- PORT ANGELES /.350) 45'7 -927 0 wA 983 53 Permit Additional desc Permi.t Fee Issue Date . ExpiraLion Date ELECTRICAL AIJTER COMMERCIAL 1-4 CTRCUI?S 86.00 Plan Check Fee 4/02/L9 valuation 9/29/1-9 BASE TEE .00 0 Exte'Ision 86. 00 oey Uni.E Charge Perth Fee summary Charged Pai.d Credi.ted Due Permi-t Fee Total PIan Check Tolal crand Total 86.00 .00 85 .00 85.00 .00 86.00 .00 - 00 .00 00 00 00 PERMTI WILL EXPIRE SIX (6) MONTHS FROM L"AST TNSPECTION INSPECTION TYPE DATE:RESULTS:INSPECTOR: DITCH SERVICE ROUGH-IN do lo #:€D FINAI dnln .&-ffi Signarure of owner or Electrical Contractor X Date: COMMENTS: IVIULTI-FAIVIILY /COMMERCIAL ELECTRICAL PERM IT APPLICATIO YED aa Public Works and Lltilities Departmeltt 3l I E. -sth Street. Port Angeles. \lA 98,162 -160..+ I 7.4735 | xrvu,.cit-vofpa.us i clectricalpennits@cityofpa.us &FCE/ NY/r e, tlo 3 + "L\n tN907 Georgiana St (Basement ) Office Space improvements 4 Circuits E N4ulti-Family Residential D Commercial / lndustrial / Public Building Square footage OWNER INFORMATION Name Olvmpic Medical Center Email: l\/ailing Address 939 Caroline St P hone ELECTRICAL CONTRACTOR INFORMATION Name Simpson Electric LLC License Mailing Address P.O. BOX 1086 PORT ANGELES, WA 98362 Expiration Date 12t11t2019 Email dlsimpson5l @qmail.com Phone 360-457 -9270 Item Service/Feeder 200 Amp. Service/Feeder 201 -400 Amp. Servrce/Feeder 401 -600 Amp. Service/Feeder 601 -'l 000 Amp Service/Feeder over '1000 Amp. Branch Circuit W Service Feeder Branch Circuit WO Service Feeder Each Additional Branch Circuit Branch Circuits 1-4 Temp Service/Feeder 200 Amp Temp Serr'ice/Feeder 201-400 Amp Temp Service/Feeder 40'1-600 Amp Temp Service/Feeder 60'l-1000 Amp Portal to Portal Hourly Sign / Outline Lighting Signal CircuiULrmited Energy - Multi-Famity Signal CircuiVLrmited Energy/First '1500 sf - Commerciat (Note $5 00 for each additjonal 1500s0 Renewable ELec Energy: sKVA System or less Thermostat (Note: $5 for each additional) Quantitv IOhl (Quantity x Unit Charge)lJnit Charoe $132.00 $160.00 $225.00 $288.00 $410.00 $5.00 $74.00 $5.00 $86.00 $102.00 $121.00 $164.00 $185.00 $96.00 $88 00 $88.00 $96.00 008614 $ $ $ $ $ U $ $ $ $ $ $ $ $ $ $ $ $ $ $113.00 $56.00 86.TOTAL Owner 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 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 certity 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 lrunicipal code, and Utility Specifications and PAlvlC 14.05.050 regarding Electrical permit Applications. 312512019 ANDREW P SITVPSON 4"4"r.-P ,// Date Print Name Signature (Owner ! Electrical Con r /Administrator) [Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa. us or faxed to 360.417.471.1] ELcoM "99i\ Project Address. Project Description: 360-460-1284 SII\4PSEL973RQ FROJECT DETAILS APPROVED ELECTRICAL INSPECTION WIRING REPORT 417-4735 NOT APPROVED Dq-FAE-T+4llloucH rN/covER . . tr SEHVICE. . . FINAL coRAEcroNS NEEDED: NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WTHIN 15 DAYS _ DO NOT REMOVE- n tr tr tr tr OATEIq )qln t1-H53 INSPECTOB=fq.P OWNER CONTRACTOF6tJ?5o*f zr*-c- ADDFIESS 1 o1 ber>Du r *t l l+ {7- DITCH w)qLL pQ " m->