HomeMy WebLinkAbout321 N Chambers StELECTRICAL PERMIT
CITY OF PORTANGELES
360-417-4735
18 00000430 Dale 3/21/18
8'7',7 730
321 N CI]AMBERS ST
06-30-00-8-1-0125-0000
ELECTRICAL ONLY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Poft Angeles
(Location Code 0502)
o$
*
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Application Nuflibe! .
Application pin nufi0rer
Property Address
ASSESSOR PAXCEL NI]MBER:
Application type descrip!ion
Subdivision Nane
Property Use
ProperEy Zoning
Application valuation
Application desc
AES radio / Fire alarm
Cont'!actor
CLALLA}I CO PUB I]OSPITAL DIST 2
DBA OIYMP]C I'1EDICAL CNTR
POP.T ANGEI,ES WA 983 523 90 9
PERFORI.{ANCE SYSTEMS
19 310 NORTH CREEK PKWY
BOTHEIJI] WA 98011
(425) 36 8 - 4201
Addi tiona]
Permil Fee
Issue Date
u:":
95.00
3 / 2"t /tB
9/23/tB
Plan Check Fee
Valuat ion
EI,ECTRICAI, AITER COMMERCIAI,
E!.IIMITED 1ST 15OO SO FT
00
0
ExpiraLion Date
Qty Unit Charge
1 .00 95 .0000
Per
ECH
Extension
95 ,00
charged Paid CrediEed Due
Permii Fee ?ota1
Plan Check ToEal
Grand Total
95.00
.00
95.00
96.00
.00
96.00
00
00
00
00
00
00
PERMIT WILL EXPIR,E SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
COMMENTS:frxa *.L..-
Signature of omer or Electrical Contractor X Date:
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Publiu \li>rks and t, tilitics I)e pa.rlment
ll I E. 5th Str$ct. Por1.\rrgcl.s. \\:\ 9816:,
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321irlS N. Chambers Street Port Anqeles, WA 98362
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Project Address
Project Descnpto n. lnstallation of AES radio to monitor existing fire alarm system
tr l\,luhi-Family Residential E Commercial / lndustrial/ Public Buiding Square tootage
O\AINER INFORMATION
Olym pic Medical Center Email
ELECTft ICAL CONTRACTOR INFORMATION
11sn1g. Performance Systems ln tegration
Mailin g Address 19310 N. Creek Pkwy #109 Bothell , wA 9801 1
Email carissa@psintegrated.com
Lieense PERF s-980t\,44
Expirat,on Oale. 71.7t'lg
pnone 425-368-4201
Item
Servioe/Feader 200 Afip
Service/Feeder 201400 Amp
Servica/FBeder.lO1g00 Amp
ServEe/Feeder 6i"1 l-1000 Arnp.
Servie/Feeder over 1U00 Amp
8rafich Cirarrit W/ Serlir:e Feeder
Branch Cirifuit W/O S€nrice Feeder
Each Adddionel B.EnEh Circ!it
Branch Circo ts l-4
Temp Service/Feeder 200 nmp
fEmp Servic€/Fsod€r 201-400 Amp-
ramp Servicar'FEeder 401-600 Atnp.
fem p, Seryioe/Feeiler 60'1 - 1000 Amp,
Port8lto Portal Ho!.ly
Sgn3l CrrcuittimitEd Energy - lrtulo-Famity
Signal Circuittimited Energy/Fir3t 1500 sf - Commercial
iNoE: $5-00 lor each Edditional I500 s0
Renewable Elec Eneruy: sKVA System ot les,s
Thermostat {Not€: $5 fureech addrton.l)
Ou.ntitv ICIA! (Quaorrty x UnitChsig.)Unlt Chr.ae
$132.m
$ 160 00
$225.00
s288.00
$410.00
$s 00
$74 00
s8B 00
s102 U0
5121,00
6164,00
$185,00
$s8_00
$88,00
$96_00
$
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0
6
$
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$ 96.00
$r13.00
656 00
I 96.00 roTAL
Ownerasdofinad by R{]W'19.28 251 (, i O'rne r will occupy the slructule licr two years afief U is electricat tletrntt is f ina rzed. (2I Owner B
req uired 10 hlre a n eledicat conkaclor f sbove tald prope(y is fcr sele rent or lease- Perfi t exp ires 6rEr six months of last ,n$€.tior
Anel readino |he above stat€ment. I hereby certiF/ lhat lam the o^'oer 0fthe sboye named prDpeag ors licenr€d eleEtrical contrector I
em making thE € lsqtrical inste llatlon oratoraiioft in comptiancs with the electncat leWE. N.E.C , ROW Chapt€r tg 86, WAC CiaDter296_
468, Ths C hl of PortAngEleS iruniqpalCade and Utlity Speqificelrqrs e PAMC 14.05,050 regsrding Electricat Pemn ACp tication s,
3t21t201A Carissa Thomson
Pnnt Name qnner E Eteclricat Contr€clor i Adminastratot)
IElectrical PermitApp ications may be submitted to City Hall or elechicatpermit$@ciiyorpa.us or faxed to J60.417.471.11
Name:
Matting Address 939 Caroline Street Port Anaeles, WA 98362 phone:
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PROJECT DETAILS
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