HomeMy WebLinkAbout939 Caroline St (25)ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4|',r -473s
PT]BLTC BUILDINGS & PAR(S
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Pori Angeles
(Location Code 0502)
.s)
NC
Application Number
Application pin number
Ploperty Address
ASSESSOR PARCEL NUMBER :
Application t!'pe descr j.pElon
Subdivision Name .
Property Use
ProperEy zoning
Application valuaEion . .
19- 0ooo12o1 Date 8/ L2 /a9
154216
939 CAROLINE ST
05-30- 00- 1- 0 -3 3 25 - 0000 -
EI,ECTRICAI ONLY
Applicatio[ desc
Lolu volEage Basement remodel
Contractor
PI]BLIC HOSPITAL DISIRICT *2
939 CAROIINE ST
PORT ANGEIJES WA 983 62
{360) 4a'/ - 1t7 0
ANGEI,ES COMMI'NICATIONS INC.
102 ROSS u,I.
PORT ANGELES, I.]A
PORT ANGEIJES WA 983 62
1350) 457-43'75
Pe!mit
Addilional desc
Permit Fee .
Is€ue DaEe
Expiration Date
106. 00
I /).2 / le
2/ Oa/20
ELECTRICA! AITTER COM},IERC IA!
Plan check Fee
Valuation
.00
0
oty UniE Charge Pet
1.00 95.0000 EcH2.O0 s.0000 EcH
EIJ-IJrr.rrTED 1ST 1500 SQ FT
EI..ADDNT LIMITED 15OO SO FT
Extsension
96 .00
10 .00
cha.ged Paid Credit.ed Due
Permrt !'ee 10tsa1
Plan Check Totsa1
Grand ?otaL
106. O0
.00
106.00
106
106
00
00
00
00
00
00
00
00
00
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signa ture of owner or Electrical Conhactor X Date:
ELECTRICAL INSPECTION
WIRING REPORT
417-4736
DITCHIfr>,AnA(-:-. RouGH lN/covER
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......SERV|CE.....
.....-.F|NAL......
COFRICTIONS NEEDED:
APPBOVED
tr ...
NOT APPROVED
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tr
tr
I]ATE INSPECIOR
zr\
DH/- y' opt-
CONTFACION
ADDBESS
L)
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WTHIN 15 DAYS
- DO NOT REMOVE_
M U LTI-FAIV I LY / COM tVI E RC IAL
ELECTRICAL PER[/IT APPLICATION
1},rblic \l'orks and Utilities Department
3l I Il. 5th Street. Port Angeles. tr'A. 98.162
,1{r0.4 I 7.4715 I u'rvx,.cit_vofpa.us I electricalpermits@)cityofpa.us
Project Address Olympic Medical Center 939 Caroline Port An geles, WA 98362
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No
Project Description Ethernet wiring and access control wiring in Basement remodel area (North Side)
! Multi-Family Residential E Commercial / lndustrial / Public Building Square footage UNKNOWN
Olympic N,4edical Center
Mailing Address 939 Caroline St. Port Angeles, WA 98362
Email: amacfeal@olympicmedlca.org
Phone 3604177000
Item fh[Sbalse
Service/Feeder 200 Amp. $132.00
Service/Feeder 201-400 Amp. $160.00
Service/Feede r 401-600 Amp. $225.00
Servrce/Feede r 60'1- 1000 Amp. $288.00
Service/Feeder over 1000Amp. $410.00
Branch Circult W/ Service Feeder $5.00
Branch Circuit WO Service Feeder $74.00
Each Additional Branch Circuit $5.00
Branch Circuits 1-4 $86.00
Temp. Serv ce/Feeder 200 Amp. $102.00
Temp. Service/Feeder 201-400 Amp $121.00
Temp. Service/Feeder 401-600 Amp. $164.00
Temp. Service/Feeder 601-1000 Amp. $185.00
Portalto Polal HoLny $96 00
Sign / Oulline Lighting $88.00
Signal Circuiulim ted Energy - Multi-Family 988.00
S,g'ral C,rcurt/L,.1teo Energy/F rst 15OO sf - Comnercial $96.00
(Note $5.00 for each additional '1500 s0
Re^ewab e Elec Elergy 5KVA System or less $113.00
Thermostat (Note: $5 for each additional) $56.00
Ouantitv Total (x Unit Charge)
'106 TOTAL
Owner as defined by RCW 1S.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 certify 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 Llunicipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electricai Permit Applications.
8 Aug,2019 Donald Simpson Donald L Si m psoon B:g.:1,ry,;lyti1oB,,B:,T!1f;[3=*
Date Print Name Signature (! Owner p Electrical Contractor / Administrator)
IElectrical Permit Applications may be submitted to City hlall or electricalpermits@cityofpa. us or faxed to 360.4'17.47111
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Name:
Name Angeles Communications lnc License: 6013865'12
Mailing Address: 102 Ross Ln Port Angeles, WA 98363 Expiration Date: 30 April, 2020
Email don@angelescommunications.com Phone: 3604574375
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