HomeMy WebLinkAbout939 Caroline St (19)Application Nuhber
Applicat.ion pin number
Property Address
ASSESSOR PARCEL NUMBER :
Application type descripEion
subdivision Name .
Property Use
Property Zoni[g
Applicatsion valuation
20 - 0O0OOO53 Date 1-/22/20
8 98419
9]9 CAROLINE ST
06- 3 0 - 00 - 1- 0 - 332s - 00 00 -
ELECTRICAL ONIY
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4t7-4735
PUBLIC BUII,DINGS & PARKS
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Applicatsion desc
Xray equipments
PI]BLIC HOSPITA! DISTRICT #2
939 CAROLINE ST
PORT ANGEIES WA 98352
135O) 4\1 - /t'7a
SIMPSON ELECTR]C
243 03 6 W HWY 101
PORT ANGELES
l36O) 4s7 -92'7A
wA 983 53
PermiE
Additional desc
Issue Date
Expiratsion DaEe
ELECTSICAI A],TER COMMERCIAL
1-4 CTRCUITS
85. O0 Plan Check Eee
t/ 22/ 2u va I uaLron
7 / 20 /20
00
0
Qty Uni"ts Charge Per
BASE EEE 85.00
Charged Paid Credited Due
Permit Fee Total
PIan Check Total
Grand Totsal-
85. O0
. o0
85. 00
86 .00
.00
86 .00
00
00
00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST TNSPECTION
INSPECTION T\?E DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN r )zilze ffi \;EP
FINAL t)z-z)zo EV ffi
Signature ofowner or Electrical Contractor X Date
Contractor
Iee summary
_ o0
.00
.00
COMMENTS:
NNULTI-FAIVIILY /COMNNERCIAL
ELECTRICAL PERI\4IT APPLICATION
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939 Caroline St OMC Port Anoeles , wA 98362Project Address:
Project Descripti 6n Altered circuit for xray Equipment voltaoe
n Multi-Family Residential E Commercial / lndustrial / pubtic Building Square footage
Narne O ympic [,4edica Center Email
Name Simpson Electric LL C License SlMPSEL9T3RO
Mailing Address P.O. Box 1086 Port Anqeles WA 98362 Expiration Date
P hone:
12t11t21
Email dlsimpson5l @gmail.com
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401 -600 Amp.
Service/Feeder 601 -'1 000 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. Service/Feeder 201-400 Amp.
Temp Service/Feeder 401-600 Amp.
lemp. Servlce/Feeder 60'1 -1 000 Amp.
Portal to Portal Hourly
Sign / Outline Lignt,ng
Signal CircuiULimited Energy - Multi-Family
Signal CircuiULimited Energy/First '1500 sf - Commercial
(Note: 95.00 for each additional 1500 s0
Renewable Elec Energy 5KVA System or less
Thermostat (Note: $5 for each additional)
Unit Charoe
$132.00
$160.00
$225.00
$288.00
$410.00
$5.00
$74.00
$5.00
$86.00
$102.00
$121.00
$164.Q0
$185.00
$96.00
$88.00
$88.00
$96.00
it Charge)
86 00
$
$
$
$
$
$
$
$
$
$
I
$
OwnerasdefinedbyRCW.19.28.261 (1) Owner will occupy the structure for h,vo years afterth;s electrical permit is finalized. (2) Owneris
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 cert,fy 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 Port Angeles Municipal Code, and Utility Specifications and PAN.,IC 14.05.050 regarding Llectrical permit Applications.
1114t2020 Andrew P Simpson 4"Arr.- p
86.0 TOTAL
Date Print Name Signature (! Ownerp Electrical Cont / Administrator)
IElectrical Permit Applacations may be submitted to City Hall or electricalpermits@cityofpa. us or fa xed to 360.417.4711]
l\4ailing Address: 939 Caroline St Port Angeles, WA 98362 phone. 360-460-1284 Rob
Ouantity
14
$_
$_
$113.00
$56.00
