HomeMy WebLinkAbout1021 Caroline Street - Building (3) x f
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Application Number . , 20-00001140 DaREPMEBMTE SALES TAX
Application pin number 207980 on your oxas 4 tax form
Property Address 1021 CAROLINE ST
ASSESSOR PARCEL NUMBER: 06 30-00-5-3-0440-0000- to the City Of Port Angeles
Application type description ELECTRICAL ONLY (Location Code 0502)
Subdivision Name . . . .
Property Use .
Property Zoning . COMMERCIAL OFFICE
Application valuation 0
Application desc T
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Owner Contractor
Olympic Medical Centex LONG BUILDING TECHNOLOGIES INC
939 CAROLINE ST 800 'SW 34TH ST SUITE A
PORT ANGELES WA 983623901 RENTON WA 98057
(206) 910-3776
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Permit ;, ELECTRICAL ALTER COMMERCIAL
Additional desc . ;
Paim4 Pea . . 96.00 plan Check Pee . . .00
sste Date . 10/06/20 Valuation 0`
Pxpiration bate 4/04/21
Qty ' Unit Charge Per Extension
1,00' - 96.0000 ECH EL-LIMITED 19T 1500 SQ FT 96.00
-----------------;--------- - - -- ---_
Pee summary Charged Paid Credited -` Due
----- >-------- ---- - - -
Permit Fee Total 96-.00 96.00 .00 00"
Flan dheck Total .00 .00 00 .00
Graxid Total 96.00 96.00 .00 .00
INSPECTION TYPE DATE, RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN . .
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
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.ELECTRICAL PERMIT APPLICATION MULTI-FAMILY / COMMERCIAL
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Public Works and Utilities
321 E. 5tbStzeet,Pnd Angeles,Wl9062 �
360.417/4735 | vvvvvvoibyofh».uo | olenbi tx,fpaxm
Project Address: 1021 Caci{iO8 St Port Angeles, 98362
Project Description: /\CC8ss Control Upgarde atth Wound Care Center
[] Multi-Family Residential, M Commercial/Industrial/Public Building Square footage:
OWNER INFORMATION
Name OMC Email:
Mailing Address: 038Caroline S0 Port Angeles,VVAB8382 phune: 3GU'417'7183
CON N
'ELECTRICAL TRACTOR IN FORIVIATI 0
Name: LONG Building Technologies License:
Mailing Address: U00N Expiration Date: 1
Emaitbdevid Phone: 541-760-6393
PROJECT DETAILS
Item Unit Charge Quantity Total(Quantity x Unit Charge)
Service/Feeder 200Amp. $132.00 $_________
Service/Feeder 2O1-40OAmp. $100.00 $__________
Service/Feeder 401'8O0Amp, *225.00 $_________
Service/Feeder O01'1O0OAmp. *288.00 *
Service/Feeder over 1O0OAmp. *410.00 $_________
Branch Circuit NV Service Feeder $5.00 $__________
Branch Circuit W/O Service Feeder $74.00 $________
Each Additional Branch Circuit $5.00 $-_____----
Branch Circuits 1-4 $80.00 $__________
Temp.Service/Feeder 280Amp. $102.00 *
Temp.Service/Feeder 2O14OOAmp. $121.00 $_________
Temp.Service/Feeder 4O1-8ODAmp. $104.00 $
Temp.Service/Feeder GO1-100DAmp. $185.00 $________
Portal Vo Portal Hourly $96.00 $_________
Sign/Outline Lighting $08.00 *-_____----
Signal Circuit/Limited Energy'Multi-Family s88.00 $-_____---'
Signal Circuit/Limited Energy/First i50Vof'Commercial $90.00 ] $ 96.y0____
(Note:$51}0 for each additional i5OOo0
Renewable Elec.Energy:5MlA System orless $118.00 *_________
Thermostat(Note:$5 for each additional) *56.00 $_______-_
$2� .00__---TCrnAL
owner aw defined byRCVK19.2B.2O1:(1)Owner will occupy the structure for two years after this electrical permit iofino|izod.(2)Owner iu
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 PAIVIC 14,05.050 regarding Electrical Permit Applications.
Date Print Name Signature(E] Owner Electrical Contractor Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711