HomeMy WebLinkAbout1021 Caroline ST - Building (2) i
MULTI-FAMILY / COMMERCIAL
ELECTRICAL PERMIT APPLICATION 3
Public Works and Utilities Department N
0
321 E. nth Street, Port Angeles, w:4 98362
360.417.4735 1 www.cityofpa.us I electricalpermits((z�.ciityofpa.us 4-
Project Address: Wound Care Building 1021 Caroline St Port Angeles, WA 98362
Project Description: Circuit for Auto Door Opener
❑ Multi-Family Residential E6 Commercial/Industrial/Public Building Square footage:
OWNER INFORMATION
Name: Olympic Medical Center Email'
Mailing Address: 939 Caroline St Port Angeles,WA 98362 Phone: Rob-360460-1284
Name: Simpson Electric LLC License: SIMPSEL973RQ
Mailing Address: P.O.Box 1086 Port Angeles,WA 98362 Expiration Date: 12/11/2021
Email: dlsimpson51@gmail.com Phone: 360-457-9270
PROJECT
1LgII1 Unit Charge, Quantity Tgtai(Quantity x Unit Charge)
Service/Feeder 200Amp. $132.00 $
Service/Feeder 201I-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 $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.
12/18/2020 Andrew P Simpson ,Arta ar,�-100 �' 1
Date Print Name Signature(❑ Owner V Electrical Co tractor/Administrator)
[Electrical Permit Applications maybe submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]