HomeMy WebLinkAbout939 CAROLINE ST - Building (4) ELECTRICAL PERMIT 1
CITY OF PORT ANGELES
360-417-4735
Application Number . . 18-00001380 Date 9/05/18
Application pin number . . . 667820
Property Address . . . 939 CAROLINE ST REPORT STATE SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-1-0-3325-0000-
Application type description ELECTRICAL ONLY on your excise tax form
Subdivision Name . . . . . . to the City of Port Angeles
Property Use . . . . . . . .
Property Zoning . . . . . PUBLIC BUILDINGS & PARKS (Location Code 0502)
Application valuation . . . 0
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Application desc
30 amp IT rcpt
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Owner Contractor
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PUBLIC HOSPITAL DISTRICT #2 SIMPSON ELECTRIC
939 CAROLINE ST 243036 W HWY 101
PORT ANGELES WA 98362 PORT ANGELES WA 98363
(360) 417-7170 (360) 457-9270
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Permit . . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc . . 1=4 CIRCUITS
Permit Fee . . . . 86.00 Plan Check Fee .00
Issue Date . . . . 9/05/18 Valuation 0
Expiration Date 3/04/19
Qty- Unit Charge Per Extension
BASE FEE 86.00
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Fee summary Charged Paid Credited Due
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Permit Fee Total 86.00 86.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 86.00 86.00 .00 .00
4'
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE '
ROUGH-IN
FINAL NbpcV-1 -17 -Wr
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
ELcOm MULTI-FAMILY / COMMERCIALS
VORTj
ELECTRICAL PERMIT APPLICATIOW'
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362 t
360.417.4735 1 www.cityofpa.us I electricalpermits@cityofpa.us W
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Project Address: Olympic Medical Center 939 Caroline St Port Angeles, WA 98362 tJ
Project Description: 1-30 Amp Outlet for IT>IDF13
❑ Multi-Family Residential ❑ Commercial/Industrial/Public Building Square footage:
OWNER INFORMATION
Name: Olympic Medical Center Email:
Mailing Address: 939 Caroline St Port Angeles,Wa 98362 Phone: 360-417-7000
ELECTRICAL CONTRACTOR • ' •
Name: Simpson Electric LLC License: SIMPSEL973RQ
Mailing Address: PO Box 1086 Port Angeles,WA 98362 Expiration Date: 12/11/2019
Email: dlsimpson5l@gmail.com Phone: 360-457-9270
PROJECT
• DETAILS
Unit Charge Quantity Total(Quantity x Unit Charge)
Service/Feeder 200 Amp. $132.00 $
Service/Feeder 201-400 Amp. $160.00 $
Service/Feeder 401-600 Amp. $225.00 $
Service/Feeder 601-1000 Amp. $288.00 $
Service/Feeder over 1000 Amp. $410.00 $
Branch Circuit W/Service Feeder $5.00 $
Branch Circuit W/O Service Feeder $74.00 $
Each Additional Branch Circuit $5.00 $
Branch Circuits 1-4 $86.00 1-4 $ 86.00
Temp.Service/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 $
Portal to Portal Hourly $96.00 $
Sign/Outline Lighting $88.00 $
Signal Circuit/Limited Energy-Multi-Family $88.00 $
Signal Circuit/Limited Energy/First 1500 sf-Commercial $96.00 $
(Note: $5.00 for each additional 1500 sf)
Renewable Elec. Energy:5KVA System or less $113.00 $
Thermostat(Note: $5 for each additional) $56.00 $
86.00 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 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-
46B,The City of Port Angeles Municipal Code,and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
9/4/2018 Andrew P Simpson �q t, � 157a_4~111
Date Print Name Signature(❑ Owner V Electrical Contractor/Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]