HomeMy WebLinkAbout939 Caroline ST - Building (6) ;. ,ti
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MULTI-FAMILY / COMMERCIAL
ELECTRICAL PERMIT APPLICATION 3
1_ Public NN'orks and Utilities Department Jv
321 1;. 5th Street, Port Angeles, 98'86?
360.417.4735 1 www utyofpa.us I electric,alpermits(4�cityofj)a.us W
Project Address: 939 Caroline St Olympic Medical Center
Project Description: CCTV Upgrades
11 Multi-Family Residential El Commercial/Industrial/Public Building Square footage: 2000
OWNER INFORMATION
Name: Olympic Medical Center Email:
Mailing Address: 939 Caroline St Phone: 360-417-7000
ELECTRICAL CONTRACTOR INFORMATION
Name: Safari Electric LLC License: SAFAREL882MC
Mailing Address: 6536 KitsaaWay- Bremerton, WA Expiration Date: 07-10-2022
Email: iay.malt seifarielectric.com Phone: 3604430992
PROJECT DETAILS
Mimi 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 $
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 $88.00 $
Signal Circuit/Limited Energy-Multi-Family $88.00 $
Signal Circuit/Limited Energy/First 1500 sf Commercial $96.00 T - $ 1 U1.UU
(Note: $5.00 for each additional 1500 so
Renewable Elec. Energy: 5KVA System or less $113.00 $
Thermostat(Note: $5 for each additional) $56.00 $
$ 1 U1.UU 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.
04/01/202Jay Malty Jr Jay E Maltry Jr TQ CPY
N9 -ft'J' kcomA�Sa/aEleckLLC.
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]