HomeMy WebLinkAbout1035 Columbia ST - Building 1
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ELECTRICAL PERMIT Q►
CITY OF PORT ANGELES �
360-417-4 735
Application Number 20-00000087 Date 1/23/20
Application pin number . . 466623 REPORT STATE SALES 7¢
`R Property Address . . . . 1035 COLUMBIA ST on your excise tax form
ASSESSOR PARCEL NUMBER: 06-30-00-5-3-0355-0000-
Application type description ELECTRICAL ONLY to the City of Port Angeles
Subdivision Name . . .
Property Use . (Location Code 0502)
Property Zoning . . . . PUBLIC BUILDINGS & PARKS
Application valuation . . . . 0
----------------------------------------- ---- ----------------------
Application desc
Garage sub panel and circuits
Owner Contractor
------ -----------------
CLALLAM COUNTY .PUBLIC HOSPITAL SIMPSON ELECTRIC
_ DBA OLYMPIC MEDICAL CENTER 243036 W HWY 101
939 CAROLINE ST PORT ANGELES WA 98363
PORT ANGELES WA 983623909 (360) 457-9270
Permit . . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc
' Permit Fee . . 157.00 Plan Check Fee .00
Issue Date . . 1/23/20 Valuation 0
Expiration Date'. 7/21/20
Qty Unit Charge Per Extension
S AO 5.0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 25.00
1.00 132.0000 BCH EL-COM 0-200 SRV FEEDER 132.00
Fee summary Charged' Paid Credited Due
a- --- ------ ---------- --
Permt Fee Total157.00 157.00 .00 .00
Platt Check Total .00 .00 .00 100
Grand Total 157.00 157.00 .00 00
IN"CTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
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PERMIT*LL EXPIRE SIX( MONTHS FROM LAST INSPECTION
Signature€ owner or Electrical Contractor X Date:
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MULTI-FAMILY / COMMERCIAL
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ELECTRICAL PERMIT APPLICATION
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Public W\rks and []111i1ie9 []Cpa[i[OCDL
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Project Address: Columbi)pt Port Angeles, WA 98362
50Am S b � fo Garage [d circuits
Project Description:
[] Multi-Family Residential 91 Commercial/Industrial/Public Building Square footage:
Nome: OMC Email:
Mailing Address: 939 Caroline St Phone: 360-460-1284
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Name: Simpson Electric LLC License: SIMPSEL973RQ
Mailing Address: P.O. Box 1086 Port Angeles, WA 98362 Expiration Date: 12/11/21
Unit Charge Quantity J9W(Quantity x Unit Charge)
Branch Circuit W/Service Feeder $5.00 5 $ 25.00
Branch Circuit W/O Service Feeder $7400 $________-__
Each Additional Branch Circuit $5.00 $--_--_-_-_-
Branch Circuits 14 $86.00 $_______
Temp. Service/Feeder 2OOAmp. $102.00 $_______--_
Temp. Service/Feeder 20140D Amp. s121.00 $-_____--_
Temp. S ime/F UO&mp. ~�^°^ `�`�"~�''m�"�v`/�^' $164.00 �,^� ' * '
Temp. - Amp. $185.00 $
Portal 0o Portal Hourly���� - ����� $96.00 �� �^ $---____--_
S�n/OuUinoUghdng ���� ' '^-r� $8800 $----___---'
Signal Circuit/Limited Energy'Multi-Family $8800 ______ $_____----_
Signal Circuit/Limited Energy/First 150Oxf' ~_ $88�OO $-_,. -----_--__-
(Nme: $5.00 for each additional 15m}mf)
Renewable Elec. Energy: 5KVA System orless *113.00 ______ $----___-__-
Thermostat(Nme: *5 for each additional) -�� � *58.00 $_-----____
$157.00___--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 ofPort Angeles Municipal Coda. and Utility Specifications and PAMC 14.05.050regonding Elemhoo|Permit Applications.
1/21/20 Andrew P Simpson a
Date Print Name Signature(E] CwnerV Electrica"I Contractor/Administrator)
[Electrical Permit Applications maybe submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]