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HomeMy WebLinkAbout1005 GEORGIANA ST - Building (2) ELE('M # -FERMiT CITY ' `ANGELES Application Number . 19-00001500 Date 9/26/19 Application :pia number . . 110000 R ' 1tT STATE SALES TAX j Property Addt+e�sS 1005 GBORGIANA ST on your eXC%Se tax form ASSESSOR PARCEL 10Rs ' 06-30-00-5-8-0220-0000- Application type description ELECTRICAL ONLY to the City of Port Angeles Subdivision Name Property Use (Location Code 0502) Property Zoning COMMERCIAL OFFICE Application valuation . . 0 _ Application desc DHP Owner Contractor CLALLAM CO PUB HOSPITAL DIST 2 SIMPSON SLECTRIC DBA OLYMPIC MEDICAL CNTR . 243036 W HWY 101 _ PORT ANGELES WA 983633909 PORT ANGELES WA 98363 (360) 459-9270 . -- - - ----7--------------------------------------- ----------- - Permit ELSMXCAL ALTER COMMERCIAL Additional desc 1-4 CIRCUITS Permit Fee 86.00 Plan Check Fee .-00 Issue Date . . . . 9/26/19 Valuation- . . .' 0 Expiration Date 3/24/20 Qty Unit Charge Per . Extension BASE FEE 86.00 -------------------------------------------------- ---------- Fee summary Charged Paid Credited _ }Due - Permit Fee Total 86:00 86.00 00 00 Plan Check Total .00 .00 .00 .00 Grand Total 86.00 86.00 00 .00 I141SPLCI'ION TYPE DATE SULTS• INSPECT'©R DITCH SERVICE ROUGH-IN f y HNAL i - tYuA�IlVlEr1T'S. ,. PEttMrf WILL t&ME SM 0I f3RV THS FROM LASTf 0aPEtt` N Signature of owner or Electrical Contractor X Date: ��...� , P r �� �� ��t, ;;i}-,. ..;�. �^ -... . . _. _. ,y MULTI-FAMILY / COMMERCIAL '� CD NO Na RM ELECTRICAL PERMIT APPLICATIONk _U Public '4N,'(_)rks and Utilities Department 321 L. 5th Street, Port Angeles, V4`A 98362 ' 360.417.4735 1 A,-Nv /.cityofpa.tis � electricalpermits%i cityofpa.us � Project Address: 1005 Georgiana St. Port Angeles d Project Description: Hook up Ductless HP ❑ Multi-Family Residential 0 Commercial/Industrial/Public Building Square footage: OWNER INFORMATION Name; Olympic Medical Center Email: Mailing Address: 939 Caroline St Port Angeles,WA Phone: 360-417-7479 ELECTRICAL CONTRACTOR ! • ! Name: Simpson Electric LLC License: SIMPSEL973RQ Mailing Address: P.O.Box 1086 Expiration Date: 12/11/2019 Email: dlsimpson51@gmailcom Phone: 360-457-9270 • • ! ECT DETAILS, &M "Unit Charae Quantity JQW'(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- 466,The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. 9/25/2019 Andrew P Simpson /0 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]