HomeMy WebLinkAbout939 Caroline St (23)ELECTRICAL PERMIT
CIry OF PORT ANGELES
360-417-4735
PUBLIC BUIIDINGS & PAR(S
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Application Number
ApplicaEion pin number
ProperEy Address
ASSESSOR PARCEI, NUMBER:
ApplicaEion E!'pe descripEion
subdivision Name
ProperEy Use
Property zoning
Applicatsion valuaEion
22 -00000468 DaLe 4/20/22
416'/tz
939 CAROI,INE ST
05 -30- 00-1-0 -332s - 000 0 -
EIECTRICAT ONIJY
Applicatsion desc
Uttra sonic Washer
PTIBLIC SOSPITAI DISTRICT #2
939 CAROI,INE ST
PORT ANGEI,ES WA 98362
l35O) 4L"1-117 t)
SIMPSON ELECTRIC
243035 W HWY 101
PORT ANGEI,ES
13601 45 t - 9270
14A 98353
Permil
Additsional desc
Permit Fee
fssue Datse
Expiration Date
EIECTRICAL AITER COI,IMERCIAL
1-4 CIPCTIITS
86.00 Plan check Eee
4/20/22 ValuaL ion
r0/1'1/22
00
0
oty Units Charge Per
BASE FEE
Charged Pald Credited Due
PermiE Fee Totsal
Plan Check Total
Grand Total
86 .00
.00
86 .00
85 .00
.00
86.00
00
00
00
.00
.00
.00
PERMIT WILL EXPIRE STX (6) MONTHS FROM LAST INSPECTION
REPORT SALES TN(
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE DATE;RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN q )u)zz^+V -.6fr
FINAL 4k lnz-JK rc\n
COMMENTS _)/
Extension
86.00
Sigrrah;re of owner or Electrical Contractor X Date:
G:\EXCHANGRBUILDING
MULTI-FAM I LY / COIVM ERCIAL
E LE CTRICAL PERMIT APPLICATION
Public Wolks and Utilitics Dcpnrtnrcnt
-'121 E. 5th Street. Porl r\n,teles. WA 9it-]62
-l 60.4 1 7.473 5 rvivrv.ci tyo lpa. us l elecLri callternt i ts(rr,crtyotpa. us
939 Caroline St OMCProject Address
Change broakor and install in Junction Box (Ultra Sonic Washer) customer is suppluing the BreakerProject Description:
OWNER INFORMATION
Namei Clallam County Public Hosoital District # 2 Email:
Mailing Address 939 Caroline St Port Angoles, WA 98362 Phone: 360417-8627
Name:
Mailing
Simpson Electric LLC License :SIMPSEL973RQ
AddresS: P.O. Box 1086 Port Angeles, WA 38362 Exp iration Date: 12-1 1 -2423
gnru11. dlsimoson5l @qmail.com Ph ens 360-457'9270
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 Amp.
Service/Feeder 401600 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.
Temp. Serurce/Feeder 601-1000 Amp.
Portal to Portal Houriy
Sign i Outline Lighting
Signal CircuiVLimited Energy - Multi-Family
Signal CircuiULimited Energy/First 1500 sf - Commercial
(Note: $5.00 for each additional 1500 s0
Renewable Elec. Energy; SKVA System or less
Thermostat (Note: $5 for each additional)
Unit Charde Ouantitv IgEl (Ouantity x Unit Charge)
$132.00
$160.00
$225.00
$288.00
5410.00
ss.00
$74.00
$5.00
$86.00
$102.00
$121.00
$164.00
$185.00
$96.00
$88.00
$88.00
$96.00
$113.00
$56.00
$
U
$
$
$
$
s
$
$
$
$
$
$
$
$
$
$
s
86.00
$_
$ 86.00 rorAL
Owner as defined by RCW'19.28.261: (1) Ownerwill occupy the structure for two years after this electrical permit is flnalized. (2)Owner is
required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expir€s afrer 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 licersed electrical contraclor. 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, Ihe City of PortAngeles Municipal Code, and Utility Speciflcations and PAMC 14.05.050 regarding Electrical Permit Applications.
4-19-2422 Andrew P Simpson
Print Name Signature (! Owner Electrical C tractor / Administrator)Date
IElectrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us]
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ELECTRICAL CONTRACTOR INFORIVIATION
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