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Home My WebLink About1021 Caroline St (4)ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 COMMERCIAI OFFICE 0 N N $t { Application Number . application pin nurnber Propertsy Addless ASSESSOR PARCEL NUMBER: AppLicalion E!,pe descripEion Subdivision Nanre Properly Use Property zonlng ApplicaEion valuaLiofl 21-00000257 Dale 3/02/2! 354705 1021 C-AROIINE ST 06-3 0-00-5 - 3- 044 0- 0000 - ELECTRICAI ONIY ApplicaEion alescTI remodel O\^'ner olympic Medical center 939 CAROLINE S? PORa ANGELES WA 983623901 OLYMPIC E],ECTR]C CO TNC 423 O TUMWATER PORT ANGEIES WA 98353 (350 ) 457-5303 Permi! Addi.tional desc Permi! Fee IBaue Date . Expiiation Date 179.00 3/A2/21 a /29 /27 .00 o QEy Uni! Cha.ge Per r.00 74.0000 EcH El,-cors,l BRANCH CIR WO/ S/E 2]..00 5.OOOO ECH EI-ECH ADDNT BRANCH CIRCUIT Exlension 74 _OO 105,00 EI,ECTRICA], ANTER COMMERCIA], Fee eummary Charged Paid Crediled Due Permit Fee Totsal Plan Check Tolal Grand ToEal 179.00 - 00 179.00 00 00 00 00 00 00 L79 L79 00 00 00 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTION TYPE DATE RESULTS INSPECTOR: DITCH SERVTCE ROUGH-IN 4lzLlu 4T7 -$tr FINAL s)nJz;sR COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature ofowner or E G:\EXCHANGE\BUILDINC lectrical Contractor X Date Plan Check Fee ValuaEion I ?oaI APPROVED tr ... ELECTRICAL INSPECTION WIRING REPORT 417-4735 NOT APPROVED DITCH @,- Yaq.t.*r-. BoucH rN/covER tr .....SERMCE. ......F|NAL..tr coBRlcnoNs NEEDED l, )AU-/--,tC-fZ tz'7 tr tr tr tr ,'ilo)2, zt- 257 INSPECIONND 6LYrr"rPt <- fz*,-C- CONTRACTOB ADDFESS NOTIFY INSPECTOR WHEN CORBECTIOI{S ABE COMPLETED WITHIN 't5 DAYS -DO NOT REMOVE_ __ ELECTRICAL INSPECTION WIRING REPORT 417-4735 NOT APPROVED DITCH.. s.,YOz2.:<.,a/ . . RouGH rN/covER D ....SERV|CE... ....,F|N4L....tr APPBOVED tr tr o o tr Nr\TE .,t,. L9J ,\SPE OWNEP LC- ^1 <- ADDPESS CORREC'-IONS NEEDED: u L NOTIFY INSPECTOR WHEN COBRECTIONS ABE COMPLETED WTTHIN 15 DAYS - OO NOT REMOVE - d-f L) *9- ELECTRICAL INSPECTION WIRING REPORT 417-47$ NOT APPROVED DITCH $.,p. 6.q61q1=. . RoucH rN/covER . . tr SERVICE. . .FINAL...tr CORRECTIONS NEEDED:f-rilAr- 12il APPROVED o...D tr D tr "Elrz )^r \t-252PEBMIT }-D* o.|A? AY)z_ CONTRACTOR ADDFESS rLoLt^J Alozl CA, lz:D 1 NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - OO NOT REMOVE_ ELECTRICAL INSPECTION WIRING REPORT 4174735 DATE INSPECTO {2 -7 OWNE CONTBACTOFot-Yin?r d ADDIIESS )0 2-)C+fLo/4?.t6- APPROVED NOT APPROVED o DITCH fii. 1*nlflo[. . . RouGH rN/covEH . SERVICE....., FINAL kJA}L Crtrl tr tr tr o tr tr - tl j z.- NOTIFY INSPECTOR WHEN CORBECTIONS ARE COMPLETED wlTHIN 15 DAYS - DO NOT REMOVE- ^r cqllat^ -iZ-\:+."AEY %X!2,.$"€ CORRECTIONS NEEDED MU LTI-FAMILY /COMME CIAL LECTRI L PERMI PLICATI Public Works and Utilities Department 321 E. 5th Srreer. Port Angeles. \lA 98,162 160.4 I 7.473,s I wvr,w.cityofpa.us I elecrricalpermits@cityofpa.us Project Address lo2t Carotine St E Multi-Family Residential E Commercial / lndustrial / pubtic Prolect Description Tl Remodel Name: Oiympic firedical Center Mailing Address 939 Caroline St., Port An geles, Wa. 98362 Email phone. 360-417-7000 Name Olymplc Eleckic Co.,lnc License OLYMPEC2S5Dl Expiration Date 03t31t2021 Phens 360-457-5303 Mailing Address 4230 Tumwater Truck Route Email maureenm@olympicelectric.net Item Service/Feeder 200Amp. Service/Feeder 201-400 Amp. Service/Feeder 40'1-600 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. Servlce/Feeder 200 Amp. Temp. Service/Feeder 20'1-4OO Amp Temp. Service/Feeder 401-600 Amp. Temp. Servrce/Feeder 601-i OOO Amp Portalto Portal Hourly Sign / Outline Llghting Signal CircuiULimited Energy - Mutti-Family Signal CircuiVLrmited Energy/First .ISOO sf - Commercial (Note: 95.00 for each additional 15OO s0 Renewable Etec Energy sKVA System or less Thermostat (Note: $5 for each additionat) Michael L. Rutten Ouantitv IOta[(Quantity x Unit Charge) 74 0 179.00 TOTA L lJnit Cha106 $'t32.00 $160.00 $225.00 $288.00 $410.00 $5.00 $74.00 $s.00 $86.00 $102.00 $ 121 .00 $ 164.00 $185.00 $96.00 $88.00 $88.00 $96.00 $113.00 s56.00 1 21 '105.00 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ s $ $ $ Owner as defined bv RCW 19.28.26'1: ('l ) owner will occupy the structure for two years after this etectrical permit is finatized. (2) owner isrequired to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires aftei 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. Iam making the electric€l installation or alteration in compliance with the etectricat laws, ru.g.i., icui cnapter t s.za, wec. chapter 296-468, The city of Port Angeles l\4unicipal code, and Utility Specifications and PAMc 14.05.050 regarding ilectricat permit Applications. Michael L. Rutten Date Print Name Signature (F Owner p Electrical Contractor / Administrator) lElectrical Permit Applications may be submitted to city Hall or epermits@cityofpa.us or faxed to 360.411.471j! !o =J s lx, l,INIt\l{ Building Square footage: _ OWNER INFORMATION ELECTRICAL CONTRACTOR INFORMATION :PROJECT DETAILS