HomeMy WebLinkAbout1133 E Park AVE - Building (2) +E Cck1+P.G1lM l a
CITY 4F'PORT ANGELES
Application Number . . . . 21-00000405 Date 4/01/21
Application pin number 134915
Property Address 1133 E PARK AVE
ASSESSOR PARCEL NUMBER: 06-30-11-5-1-0800-0000-
Application type description ELECTRICAL ONLY
subdivision Name . . . .
Property Use . .
Property Zoning . RESIDENTIAL MEDIUM DENSTY
Application valuation 0
-_-_ _ --------- _- -
Application desc
Door access'
Owner Contractor
LAUREL�PARK AID PROPCO LLC COSCO FIRE PROTECTION INC
C/O ASSISTED LIVING CONCEPTS 4308 S 131ST PL
330 N WABASH AVE SUITE 3700 SEATTLE WA 98168
CHICAGO IL 60611 _ (949) 245-6491
(312) ;725-7U0
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Permit' . . . ELECTRICAL ALTER COMMERCIAL
Additional desc
Permit Fee 96.00 Plan Check Fee .00
Issue Date . 4/01/21 Valuation . . 0
Expiration Date 9/28/21
4ty Unit Charge Per Extension
1.00 96.0000 ECH EL-LIMITED 1ST 1500 SO FT 96.00
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Fee summary Charged Paid Credited" Due
----------------- ------- -- - -
Permit Fee Total' 96.00 96.00 .00 .00-
Plan Check Total .00 .00 .00 .00'
Grand Total 96.00 96.00 _00 .00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Cade 0502)
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-INAIR
FINAL "
COMMENTS:
PERMIT WILL EXPIRE SJX`(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G:\EXCHANGE\13UILDING
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MULTI-FAMILY / COMMERCIAL
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ELECTRICAL PERMIT APPLICATION
Public Works and Utilities De lD�Qt
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321 F. 5\h SbceL Port Angeles. VV& g#382 \
360.417.4735 | xww.oitywfpnuw | e lectr iou|poon its(�ikiiyo6pu.us a
Project Address: 1133 E. Park Avenue Port Angeles, \8/A98362
Project Description: Memory Care Facility
[] Multi-Family Residential 0 Commercial/Industrial/Public Building Square :
OWNER INFORMATION
Name: Extreme Elements Email: Joni&extremeelements.us
Mailing Address: po box 3378 Central Point, Or 98502 Phone: 206-888-7650
ELECTRICAL CONTRACTOR INFORMATION
Name: Cosco Fire Protection License: COSCOFP935MS
Mailing Address: 2501 SE Columbia Way, Suite 100 Vancouver,WA 98661 Expiration Date: 7/2/21
Email: ctyree@coscofire.com Phone: 360-883-6383
PROJECT DETAILS
112M Unit Charae Qual3tily J2W(Quantity x Unit Charge)
Branch Circuit W1 Service Feeder $5.00 $
Branch Circuit W/O Service Feeder $74.00 $
Each Additional Branch Circuit $5.00 $----______
Branch Circuits 14 $86.00 $
Temp. Service/Feeder 2OO Amp. �.� �� $1O2�0 ' $
Temp. GemimdFoener2U14u0}Amp. ����� $121.00 $
Temp.
Temp. 8ervice/Feed u
Portal ho Portal Hourly
Sign/Outline Lighting ������� /,'������� ^�����0����v' $88.00 ^'�� ��� `�
Signal Circuit/Limited Energy-Multi-Family $88.00 $
Signal Circuit/Limited Energy/First 1500 sf-Commercial $96.00 1 ,$ 96L10
Renewable Elec. Energy: 5KVA System or less *----______
Thermostat(No0e: oS for each additional) �^�:,�`� "��`n � *`` $--___-___
$ 961TgTAL
Owner as defined by RCW19.28.261:(1)Owner will occupy the structure for two years after this electricalpermit is finalized.(2)Owner is
required to hire an electrical contractor ifabove said property im for sale, rent urlease. 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.
3/31 Chris Tyree
Date Print Name Signature(VI Owner V Electrical Contractor/Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]