HomeMy WebLinkAbout939 ST - Building ...�
Eh SAL PERMIT
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Application Number 19-00001255 Date 8/19/19
Application pin number . 478100 REPORT STATE SAL
rE.S TAX
Property Address 939 CAROLINE ST t?1t your@XGY3@ fax form
ASSESSOR PA4CEL NUMBER: 06-30-00-1-0-3325-0600-
Agplicstion type description ELECTRICAL ONLY to the City of Port AngeleS
Subdivision Name . . (Location Cade 0502)
Property Use .
Property Zoning'. PUBLIC BUILDINGS & PARKS
Application valuation 0
Application desc
Heat pump replacement ' . `
-- --------- --------- - --- -- ----------------------------------------
Owner Contractor
----------- --- --*-----------
PUBLIC HOSPITAL DISTRICT #2 SIMPSON ELECTRIC
939 CAROLINE ST 243036 W HWY',101
PORT:ANGELES WA 8362 PORT ANGELES WA 98363
(360) 417-7170 , (360) 457-9270
Permit ELE RICAL ALTER CON$`IERCIAL
Additional desc 1-4 CIRCUITS
Permit Fee 16.00 Plan Check Fee ." .00
Issue Date 8/19fi9 Valuation . . . 0
Expiration Date 2/15J20 {
Oty 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 .06 .00 00 .00
Grand Total 86.00 86.00 00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN
RutA
COM TENTS:
PERWr WILL FJ WE SIX(6)MON'tRS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
i
MULTI-FAMILY / COMMERCIAL RE( ��= ,
ELECTRICAL PERMIT APPLICATION BUG
Pi.lblic Nk"orks and Utilities Department
"1 E. 5th Street. Part .Angeles, VN`A 98362 `
360.417.4735 1 vtww.cityofpa.us i electricalperinits�cityofpa.us 1v
Project Address: 939 Caroline St. (Annex)
Project Description: Reconnect replacement Heat Pump
❑ Multi-Family Residential 0 Commercial/Industrial/Public Building Square footage:
OWNER INFORMATION
Name: OMC Email:
Mailing Address: 939 Caroline St Port Angeles,WA 98362 Phone. 360-417-7621
ELECTRICAL CONTRACTOR iR , i
Name: Simpson Electric LLC License: SIMPSEL973RQ
Mailing Address: P.O. Box 1086 Port Angeles,WA 98362 Expiration Date: 12/11/2019
Email: dlsimpson5l@gmall.com Phone: 360-457-9270
PROJECT
lt�m Unit Charae QuantilM 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 601-1000Amp. $28800 $
Service/Feeder over 1000 Amp. $410.00 $
Branch Circuital/Service Feeder $5.00 $
Branch Circuit W/O Service Feeder $74.00 $
Each Additional Branch Circuit $500 $
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 $9600 $
Sign/Outline Lighting $8800 $
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.
8/15/2019 Andrew P Simpson .AMal�/0 :2'�
Date Print Name Signature([] Owner V Electrical Contractor/Administrator)
[Electrical Permit Applications maybe submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]