HomeMy WebLinkAbout939 Caroline St (29)t
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PUBLfC BUILDINGS & PARKS
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REPORTSTATE SALES TAX
on your excise tax fo(m
tothe City of Put Angeles
(Location Code0502)
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Application Number
Application pin nut,lber
Property Address
ASSESSOR PARCE],- NOMBER:
Applicatioo type descri.ption
Subdivision Name
Propertsy Use
Property Zoninq
Appli.cat.ion valuation
19 -00000670 Date 5/09/19
s49{90
939 CI.R,OLINE ST
06-30 -00- 1-0 -3325- 0000-
ELECIRICAL ONI.Y
ApplicaLion desc
Surgery Chiller
Owner Contractor
PUBLIC HOSPITAI DISTRICT +2
939 CAIOLINE ST
PORT A}IGELES WA 983 62(350) 4t 7-7170
OLYMPIC ELECTRIC CO INC
4230 TUI!{WATER
PORT ANGEI-ES WA 983 63(360) 45?-5303
Permi t
Additional desc
Permit Fee
Issue Date
Expiration Datse
317.00
5/09 /19tr/ as/ 19
ELECTRICA! ALTER COI4MERCIAL
Plan Check Fee
val.uation .
00
0
Qtv
5 .00
1 .00
1. 00
Unit Charge Per
5 .0000 EcH
132 .0000 EcH
150.0000 EcH
EL-ECH A'DNT BRANCH CIRCUIT
E!-COM O-2OO SRV FEEDER
EL-COM 201-4OO SRV FEEDER
Exten6ion
25.00
132.00
160.00
Charged Paid CrediEed Due
Permit F'ee Total
Plan' Check Total
Grand Total
317. O0
.00
317.00
317.00
.00
317.00
00
00
00
00
00
00
INSPECTION TYPE DATE:RESULTS:INSPECTOK
DITCH
SERVICE
ROUGH.IN elas I*w w
FINAL .{P wr
COMMENTS:t
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PERMIT WILL E)(PIRE SD( (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X
ELESTRICAL PERMIT
CITY OF PORT ANGELES
36G4.174735
fir^1ro
Date:
APPROVED
ELECTRICAL INSPECTION
WIRING REPORT
417-4736
NOT APPROVED
DITCH
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.....F|NAL...
COF.BECTIONS NEEDED
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LNSPEC-L70DATE
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CONTBACTOF
ADDFESS
NOTIFY INSPECTOR WHEN CORBECTIONS
AFE COMPLETED WTHIN 15 DAYS
_ DO NOT REMOVE-
tJ
ELECTRICAL INSPECTION
WIRING REPORT
417-4735
APPROVED
.......D|TCH.....
. . ROUGH IN/COVER
......SERV|CE....
FINAL
CABRECTIONS NEEDED: RG-'^D \,,A t9 A{ I ?,)t> 4,ta:-
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DATE
76
NSPECTOR
CONTRACTON
s
NOT APPR
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NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED wlTHIN 15 OAYS
- DO NOT REMOVE_
Z4
IVULTI-FAIMI LY / CO]VIIUERCIAL
ELE CTRICAL PERMIT APPLICATION
Public Works and Lltilities Department
321 E. 5th Srreet. Porl Angeles, \4i4, 98.162
160.4] 7.4715 I u,rvrn.citl,ofpa.us i electlicalpermits@citycfpa.us
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Project Address 939 Caroline St.
Project Description New 400amp & 125amp Panels for Suroery Chiller Re placement Project
E Multi-Family Residential E Commercial / lndustrial / Public Building Square footage
Name Olympic [-4edical Center
Mailing Address 939 Caroline St., Port Angeles, Wa. 98362
Email
phone.360-417-7000
Name Olvmpic Electric Co., lnc Licens e: OLYMPEC285D1
Expiration Date 03t31t2021
Phone: 360-457-5303
Mailing Address 4230 Tumwater Truck Route
Email: maureenm
Item
Servic€i Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401-600 Amp.
Service/Feeder 601- 1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit w/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feedsr 40'1-600 Amp.
Temp. Service/Feeder.60'1-1 000 Amp
Portal to Portal Hourly .r''
Sign i Outline Lighting ., t,'
Signal Circuiulimited Energy - Mult:Family
Signal CircurUL,mrted Energy/First '1500 sf - Commercial
(Note: $5.00 for each additional 1500 si)
Renewable Elec. Energy: 5KVA System or less
Tnermostat (Note. $5 for each addrtronal)
unit Charge
$132.00
$160.00
$225.00
$288.00
$410.00
$5.00
$74.00
$5.00
$86.00
$102.00
$121.00
$164.00
Charge)
13? OO
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$ 160.00
$185.00
$96.00
$88.00
$88.00
$96.00
$113.00
$56.00 --::":-
$
$
$3'17.00 TOTAL
Owner as defined by RCW.19.28.261: ('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 eiectrical 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-
46B, The City of PortAngeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
IVichael L. Rutten
Date Print Name Signature (F Owner p Electrical Contractor /Administrator)
IElectrical Permit Applications may be submitted to City Hall or epermits@cityofpa. us or faxed to 360.417.47111
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