HomeMy WebLinkAbout1029 Columbia StApplication Nunbe! .
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Ploperty Address
ASSESSOR PARCEL NWBER I
Application type deEcript.ion
Subdivision Name .
ProperEy U€e
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Application valuatsion
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
18 00 00042 5 Dale 3/27/!8
10195 0
1029 COII,'MBIA ST
06-30 00 5,3-0345-0000-
ELECTRICAL ONLY
PUBLIC BUILDINGS & PARKS
0
0$
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Applicaeion deBc
A!15 raoro / l'tre alarm
Contractor
OLYMPIC MEMORIAL HOSPITAL
93 9 CAROLINE ST
PORT ANGELES WA 983 52
PERFORMANCE SYSTEMS
19310 NORTH CREEK PKWY
BOTHELI, WA 98011
(425 ) 3 68 -42 01
96. 00
3 /2'7 /tB
9/23/t8
Plan gheck Fee
val.uacion
ELECTRICAL ALTER CO],1I"1ERCIAL
00
0
ary unl E uharge
1.00 95.0000
Per
ECH EL-LIMITED lST 15OO SQ FT
Exte11sion
95.00
Fee sudnary Charged Credited Due
Permit Fee TolaL
Grand Total
96.00
.00
96.00
96.00
.00
95.00
.00
.00
.00
00
00
00
INSPECTION TYPE DATE:RESULTS:
DITCH
SERVICE
ROUCH.IN
FINAL
COMMENTS:EQtfz6-
PERMIT WILL EXPTRE SIX (6) MONTI{S FROM LAST INSPECTION
Signature ofowner or Electrical Contractor X Date ;
Permit
Addi.lional desc
Permit. Fee
lssue Date
Expiration Date
NSPECTOR:
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Proiect Address 1029 Columbia Street Port An geles, WA 98362
Project Descriplion lnstallation of AES radio to monitor existing fire alarm system
tr l\,luhi-Family Residenliai E Commercial I lndustrlal / Pubiic Bu tding Square rootage:
Narne Olympic [,4edical Center
Marlrng Address 939 Caroline Street Port Anqeles. WA 98362
Effai
Phone:
Narne Performance Systems lnteqration
Mailing AddrEsE 19310 N. Creek Pkwy #109 Bothell , wA 9801 1
Email carissa@psintegrated.com
License PERFOS.980M4
Exprra
pvsns 425-36a-42O1
tk)n aa]F-. 1127118
Iteft
Servide/Feeder 200 Afip
Servicei Feeder ?0'l{00 Amp
Seryice/FEEder.lO 1 $00 Amp.
Service/Feeder 601l 000 Arnp.
SErvice/Feeder oler 1000 Amp
Branch Ciret t W Serviee Feeder
Branch Cirq] t WO Service Feeder
Each Additional BlEn,rh C irc! ii
Branch Circoits 14
Iemp Servicer'Feeder ?00 Amp
fE nr p Ser,/ic€, FEedsr 201 -400 Aer p-
Trmp. Ser-rica/F€€{€r 401-600 AInp-
Temp, Seivice/Feeder 60 1 -1 000 Amp,
PEdal to PBrtgl Hdudf
$ignal Crrcuit/Liflritsd Enetgy - Mul[-Family
Signal Crrcuittimited Energy/Firs.t 150O sf -Commercial
{Nob: 95.00 foreBch Edditional 1500 sD
ReFeyJable Elec En€rEy: sKVA System of less
Thermostst lNEte: $5 for eech addilionell
Ooadtitv Iclsl (Queotity r UnitChrigrl
96.00
Unit Chr.cq
$132 00
$ 160 04
$225.00
$288.m
$41o. oo
$s 00
$74 0d
$s Eo
$66.00
Sr02.oo
s16,r,00
s185.00
s96,00
$8e,00
$
$
$
$
$
$
$
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$
$
$
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$
$113.00
$56 0'0
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g 96.00 T0TAL
Owne.asd€lrn€d by RCWlE-28.251 (t 1 O*!re I ,,,!rill oscupy the structur" lor two yeaE afref Is eteclriEa Fermf is f ina]ired. 12I Olvner rg
leqlired to hire aI e lectricaL conllactor f above said fmperly is for sale. rentor ]eagt PermilerF.es HaErsrx months ofla3t insF€ction
Afrel reading the Stove statement, I her€by cedit/ lh at I at1 the owne I of the sbdve n Hrned prDperty Dr s icens€d electrics I contracto r I
em mak ng tha € leqtr csl insta lBtron q. a lteralroft in comiliian€€ ,rith the Electr€al lavrE N.E C , RCW C hapter I S 2E, WAC Chapter 296-
468, Ths Ciry of PortAngsleF Municipsl C0dE, and Utility Specficatii]nE a PArvlC l4-05,050 regardin! El€ctrical Pemt(AFpliaatons,
3/2112018 Carissa Thomson
Date S Owner E Eleckic€l ContrEctor / Adininisiratori
[Electrical PermitApplEations may be submitted to City Hall or elechicalpefinits@cityofpa-us or faxed to 360.417,,u 11]
ELcoil
I Public \\trrks anil l . tilities l)eparlrnenL
3: I E. sth Slrcct. Porl r\ngclcs. t&i\ 9816l
1d0.4 17..1?15 | nwr+'.citlolpa us I clcctrirslprrmitsi.liuir,rr:li:rr.us
OIIIIT,IE R IH FERfiJIAT ION
ELECTRICAL COIITRACTOR INFORIIIATIOH
PROJECT DTTAILS
I
Prlnt Name