HomeMy WebLinkAbout1107 Georgiana St - BuildingApplication Number 10 00000911
Application pin number 812385
Property Address 1107 GEORGIANA ST
ASSESSOR PARCEL NUMBER 06 30 00 8 1 0135 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning COMMERCIAL OFFICE
Application valuation 0
Application desc
200 amp service
Owner
CL CNTY PUBLIC HOSPITAL DIST 2
DBA OLYMPIC MEDICAL CENTER
939 CAROLINE ST
PORT ANGELES WA 98362
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
ELECTRICAL ALTER COMMERCIAL
172056
119 90
8/24/10
2/20/11
Qty Unit Charge Per
1 00 119 9000 ECH EL 0 200 SRV FEEDER
Charged Paid Credited
INSPECTION TYPE DATE.
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
Contractor
SIMPSON ELECTRIC
243036 W HWY 101
PORT ANGELES
(360) 457 9270
Plan Check Fee
Valuation
119 90 119 90 00
00 00 00
119 90 119 90 00
elz.4 I ►o
c312-11 hp
Date 8/24/10
RESULTS
th,T7
WA 98363
00
0
Extension
119 90
Due
00
00
00
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTOR.
Date.
CITY OF PORT ANGELES PERMIT APPLICATION
Rolldtng Division/Electrical Inspections
321 Past Fifth Street P,O. Ron 11S4 .Port Angeles Washington, 95362
Ph (360) 417 -4735 Fax: (360) 417 -4711
Date: 8
1 2 Single Family Dwelling Multi- Family or2r2mmeniar Cammemiel Addition 1 Altered r i Remodel Repair
Plan Review May Re Re uined, Please Complete Electrical Plan Review I� Sheet
Job Address:
Building Square Footage:
Doacz1p0o0 of above
Service/Feeder 200 Amp.
SetvicelFeeder 201 -400 Amp.
Service/Feeder401 -600 Amp
SarvicelPeeder801 -1000 Amp.
ServicefFeeder over 1000 Amp,
Branch Circuit W/ Servirn Feeder
(Branch Circuit W/O Service Feeder
Each Additional Branch C$rcult
Temp. Service/ Feeder 200 Amp,
Temp, ServlcelFeeder 201400 Amp.
Temp. Service /Feeder 401 -600 Amp.
Temp. Service/Feeder 801 -1000 Amp
Portal to Portal Hovey
Sign/Outline IJghdng
Slpnal Mad/ Limited Energy I First 1500 a f.- Commercial
Note: $5.00 for each additional 1500 sf
Signal Circuit/ Limited Energy 1 2 Family OwelirlN
Signal Circuit/ Limited Energy Muhl Family Dwelling
Manufactured Homo Connection
Renewable Bar:Meal Energy -SKIM System or Less
'thermostat
KINMSIBMCKOL2t
Fhet 1300 Square Ft.
Each Additional 50D Square FL or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
U
119.90
145,50
204.60
282.20
372.00
2.60
73,50
2.80
92.70
110,30
148.70
167.90
95.90
88.20
95.90
63.90
63.90
$119,90
102,30
56.00
$110.30
35,20
73,50
110.30
gly
TIED
AUG 2 4 2009
ELECTRICAL
INSPECTIONS
Owner information Contractet Erttotl
Name:. C�.m Name: c gIE{�'�7 i' L Lt
Mewing Ad as 1 35 m i,1i15-" Mlalling s: a 21
City: State; 2tp k city: a srate:'W{
Phone; 9 j L-.._1000 Fax Phone: 7,=.9 >r ,0
License# Exp, t cerm #1 Exp .Z:&?4j.. 3
Total IQL1� tu""166
Owner es defined by RCW.19.28.261 (1) Owner will occupy the structure for two years after fits electrical pawn t is finalized. (2 i C seer is requlned
to hire an electrical contractor It above said property Is for sale, rent or lease. Permit expires after six months of last inspection.
After reading the above statement, t hereby certify that 1 am the owner of the above named pmperty or a licensed electrical corms w or. i am making
the electrical installation or alteration in compliance with the electrical laws, N.P.C., RCW, Chapter 19,28, WAC. Chapter 298.4 E he City of Port
Angeles Municipal Code, and Utility Specification and PAMC 14,05.080 regarding ElecMcal Pennil Applications,
Sig re of owner, electrical or electrlcat administrator: p Co* ctetr
and* e'yt
e
nwtrirt A dtM112010 n
-~+'
This certificate is issue
certifying that at the t'
regulating.building-c
Business name:
Business address~'
Property owner:
Property owner's
Automaticfire spri
Use & occupancy c
Building permit num
Type of construction:
Occupant load:
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