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Home My WebLink About216 E 5th St - Building ELECTRICAL PERMIT 8 CITY OF PORT ANGELES CIA 360 -4] 7 -4735 Q� Application Number 11- 00000358 Date 4/22/11 Application pin number 793794 Property Address 216 E 5TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -2 -0020 -0000- on your excise tax form Application type description ELECTRICAL ONLY Subdivision Name to the City of Port Angeles Property Use (Location Code 0502) Property Zoning COMMUNITY SHOPPING DISTR Application valuation 0 Application desc 1 circuit roof top unit Owner Contractor WHITE JOHN /CONSUELO STRAITS ELECTRIC 216 E 5TH ST PO BOX 2914 PORT ANGELES WA 983623008 PORT ANGELES WA 98362 (360) 452 -9104 .4 5'1 6M -I v Permit ELECTRICAL ALTER COMMERCIAL Additional desc Permit pin number 184200 Permit Fee 73.50 Plan Check Fee .00 Issue Date 4/22/11 Valuation 0 Expiration Date 10/19/11 Qty Unit Charge Per Extension 1.00 73.5000 ECH EL- BRANCH CIRCUIT WO /FEEDER 73.50 Fee summary Charged Paid Credited Due Permit Fee Total 73.50 73.50 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 73.50 73.50 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN Z l 2,Z G (Z 4N FINAL 2 t 11 z T V rqq COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G: \EXCHANGE \BUILDING Apr 20 11 01:25p Christie Tucker 360- 452 -0741 p.1 t VE City of Port Angeles Permit ApplicaFon t i ,�.�„?0,1_, f r 'y F Building DivlslonlEtectrical Inspections L` s 321 East FINK Street P.O. Box 11503 Port Angeles Washington, 98362 APR 2 1 2017 Ph: (360) 417-4735 Fax: (360) 417 -4711 Da'e: ?L I ELECTRICAL INSPECTIONS 1( 1 2 Single Family Dwelling Multi Family or Commercial' Commercial Addition 1 Alteration I Remodel Repair Plan Review May Be,R quired, Ple se Co let Iec tricaS Plan Review information Sheet Job Address: 4 7 Building Square Footage: Description of above )/O L rc '��f t/L.r(.i_ -f GL,`' ?I/i 6 ,t --r C Li :LcCLh7 LZ( U) rr t p ii v/ 0 C or ryi 0 e (1- Cnrrnerinformalion i Cpntr_actor-Inform on Name: 2 1{ L Name: ..Y L Lc 2 l Ma Address: S 1 7 Mailin A dress: 1-'0 i4(5( 5i/ City: State: Zip: City: V ft Stale: Zip: �L Phone: Fax Phone: -24 f `f `1r 4 7 6 S 0J'4/ License 1 Exp. License Exp. j K-a "1� L cid_ Unit Charge Qty Total IOty Multiplied by Unit Charges $119.90 Service/Feeder 200 Amp. $145.50 Servicefeeder201.400Amp. 5 204.60 Service /Feeder 401-600 Amp. 262.20 5 Service,/Feeder 601 -1000 Amp. 372.50 Service/Feederover 1000 Amp. 2.60 Branch Circuit WI Service Feeder 73.50 l 5 7-5 Branch Circuit W1O Service Feeder 2.60 Each Additional Branch Circuit 5 92.70 5 Temp. Service! Feeder 200 Amp. 110.30 '5 Temp. Service/Feeder 201 -400 Anp. $146.70 Temp. Service/Feeder 401 -600 Amp. 5167.90 Temp. Service/Feeder 601 -1000 Amp. 95.90 Porta: tc Portal Hourly 85.20 5 Sign/Outline Lighting 95.90 Signal Circuit/ Limited Energy Commercial. Additional 1500 55.00 63.90 Signal Circuit! Limited Energy -1 2 Family Dwelling 5 63.90 Signal Circuit/ Limited Energy Multi-Family Dwelling 5119.90 Manufactured Home Connection 5102.30 5 Renewable Electrical Erergy 5KVA System or Less 5 110.30 3 First 1300 Square F L 5 35.20 3 Each Additional 500 Square Fl. or Portion of 5 73.50 Each Outbuilding or Detached Garage 5 110.30 Each Swimming Pool or Hot Tub 5 56.00 n Thermostat 17 _1 Total Owner as defined by RCW- 19.28.167: (1) Owner will occupy the structure for two years alter this electrical permit is finalized. (2) Owner 1s required to hire an electrical contractor N above said properly is for sale, rent or lease. Permit expires after six months oflast inspection.; Afteyreadinq'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 alteratlon Incompliance 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. i Signature of ownef electrical contractor or electrical administrator 0 Cash i 1; Check 1 Date: C7 Credit Card p I PREPARED 9/28/09 9 14 49 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 9/28/09 ADDRESS 216 E 5TH ST SUBDIV TENANT NBR CLAY BEZEL CONTRACTOR ANGELES HEATING INC PHONE (360) 457 0111 OWNER JOHN /CONSUELO WHITE PHONE PARCEL 06 30 00 0 2 0020 0000 APPL NUMBER 09 00000958 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME99 01 9/23/09 JLL MECHANICAL FINAL TIME 01 00 9/23/09 DA September 22 2009 8 46 13 AM 1pangrle BOB 460 2314 MECHANICAL FINAL HEAT PUMP AFTERNOON September 23 2009 4 45 50 PM jlierly anchor condenser to pad /jll ME99 02 9/28/09 MECHANICAL FINAL September 25 2009 4 18 45 PM 1pangrle BOB 460 2314 MECHANICAL FINAL HEAT PUMP (ANCHORED OUTDOOR UNIT) COMMENTS AND NOTES PREPARED 9/23/09 8 28 50 INSPECTION TICKET CITY OF PORT ANGELES INSPECTOR JAMES LIERLY ADDRESS 216 E 5TH ST TENANT NBR CLAY BEZEL CONTRACTOR ANGELES HEATING INC OWNER JOHN /CONSUELO WHITE PARCEL 06 30 00 0 2 0020 0000 APPL NUMBER 09 00000958 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME99 01 9/23/09 ,+LL SUBDIV MECHANICAL FINAL TIME 01 00 September 22 2009 8 46 13 AM 1pangrle BOB 460 2314 MECHANICAL FINAL HEAT PUMP AFTERNOON COMMENTS AND NOTES PHONE (360) 457 0111 PHONE PAGE 6 DATE 9/23/09 f 4mckept. to61-13/2(0&_ -'Lc 6)-/L pc Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc Circuits for heat pump Owner WHITE JOHN /CONSUELO 216 E 5TH ST PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge Per 1 00 57 5000 ECH Fee summary Permit Fee Total Plan Check Total Grand Total INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS WA 983623008 ELECTRICAL ALTER COMMERCIAL 154039 57 50 9/23/09 3/22/10 Charged 57 50 00 57 50 ELECTRICAL PERMIT CITY OF PORT ANGELES 360- 417 -4735 09 00000981 480824 216 E 5TH ST 06 30 00 0 2 0020 0000 ELECTRICAL ONLY COMMUNITY SHOPPING DISTR 0 Contractor NORTH PENINSULA ELECTRIC 761 FRESHWATER PARK RD PORT ANGELES WA 98363 (360) 477 1764 EL BRANCH CIRCUIT WO /FEEDER 57 50 00 57 50 Plan Check Fee Valuation Paid Credited Due DATE RESULTS 121 10 (*pi 00 00 00 Date 9/23/09 0 0 00 00 00 0 Extension 57 50 Signature of owner or Electrical Contractor X Date INSPECTOR. 2009 -09 -21 15:59 City of Port Angeles Permit Application Building Div%W Electrlal Inspections 321 Fast Fifth Sheet P.Q. Box 1130 Port Angeles Washington, 98362 Ph: (350))417 -4735 Fax: (960) 41774711 Date: 1 1 1 2 Single Family Dwelling Multi-Family or Commercial` Commercial Addition I Alteration I Remodel I Repair° Plan Review May Be R Please C lets, Plan Review Information Sheet Job Address: (7) Building Square Footage: Description of above \A\ CL Owner Information Name: C I �t� \F' Ae Mailing Address: 2— 1 z City 1 t State: 1.s.. Zip: Phone: Fax: License I Exp. Unit Chew 93.75 $113.75 $160.00 $205.00 $291.25 2.00 57.50 2.00 72.50 86.25 $116.25 $131.25 75.00 69.00 75.00 50.00 50.00 93.75 80,00 86.25 27.50 57.50 86,25 43.75 NORTH PENINSULA ELEC 360928 4841 P.1/1 Signature of owner, electrical contractor or electrical administrator far §E(F,- 2 3 7009' L C J`'� C\` \*C'C) INSPECTIONS Contractor Information Name: c (le ��z\ r�S k.t e_ r\ `C Mailing Address: 1 La c. 3 h 1 r l u.'� �F— City: 4:\ State'. Zip: r Phone: 1 Fax: 1 Z. 0 1 License Exp. fc1 rl 3�. -t'" 2— Total (Qty Multiplied by Unit Chang) service/Feeder 200 Amp. Service/Feeder 201-400 Amp. Service/Feeder 401.600 AIM- S Service/Feeder 601 1000 Amp. Service/Feeder over 1000 Amp, Branch Circuit WI Service Feeder C 1,,,V2Branch Circuit W/O Service Feeder Each Additional Branch Circuit Temp. Service/ Feeder 200 Amp. Temp. Service/Feeder 201-400 Amp. emp. ServicelFeeder 401-600 Amp. 'temp. Service/Feeder 601 -1000 Amp. Portal to Portal Hourly Sign/Outline Lighting Signal Circuit/ Limited Energy Commercial Signal Circuit/ Limited Energy 1 2 Family Dwelling Signal Circuit/ Limited Energy Multi- Family Dwelling Manufactured Home Connection Renewable Electrical Energy 5KVA System or Less Firs/ 1300 Square Ft, Each Additional 500 Square FL or Portion of Each Outbuilding or Detached Garage Each Swimming Pool or Hot Tub Thermo tat $L5 1 `'i' Cash o Check Q—t a cards L_.- Owner as defined by RCW.19.2&261: (f) Owner will occupy the structure for two MIS after this ekithical permit is finalised. (2) Owner Is required to titre an electrical contmtiw N agave said properly Is for saki, rent or lease. After reading the above statement, I hereby certify that I am the owner of the above named properly or a licensed electrical contractor. I am making the electrical Installation or alteration in compliance with the electrical laws, N.E.C. RCW. Chapter 19.20, WAC. Chapter 298488, The City of Port Angeles Municipal Code, and Utility Specifications. 0 0 53 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc REPLACE HEAT PUMP Owner JOHN /CONSUELO WHITE 216 E 5TH ST PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge Per BASE FEE 1 00 14 8000 EA ME FURN /HP /FAU Fee summary Charged Permit Fee Total Plan Check Total Grand Total 69r/ 7 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES WA 98362 T:FormsBuilding Division/Building Permit WA 983623008 MECHANICAL PERMIT REPLACE HEAT PUMP 153734 64 80 9/17/09 3/16/10 64 80 00 64 80 09 00000958 895542 216 E 5TH ST 06 30 00 0 2 0020 0000 CLAY BEZEL MECHANICAL APPL PERMIT COMMUNITY SHOPPING DISTR 5000 Contractor ANGELES HEATING INC 2114 W 8TH ST PORT ANGELES (360) 457 0111 Paid Credited Due 64 80 00 64 80 OR 5 TON 00 00 00 Date 9/17/09 WA 98363 Plan Check Fee 00 Valuation 0 Extension 50 00 14 80 00 00 00 IF n ate,/ i Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void If work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the perfq>;mance of construction. -P Date Print Name Signature fo Contractor or Authorized Agent Signature of Owner (if owner is builder) IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type FOUNDATION Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs PLUMBING Under Floor I Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow Water AIR SEAL. Walls Ceiling FRAMING Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION Slab Wall Floor Ceiling MECHANICAL. Heat Pump I Furnace! FAU Ducts Rough-In Gas Line Wood Stove Pellet Chimney Commercial Hood "Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping I SHORELINE. T Forms /Building Division /Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NO TICE FOR INSPECTIONS Building Inspections 417 4815 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 Inspection Type Date Accepted By Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 Comments FINAL Date Accepted by FINAL Date Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Date Accepted By a- 74?- 1A nsS Applicant c ./-48s#71. fA- C Property Owner .1� /,C,`;f- Property Owner's Address _2l y--'- S --.ta Contractor 4„� l„J Irv- Contractor's Ad.ress 911 q 1,,i /j_ 1 4 License t4�G1�Liz'q? L Expires //j PROJECT ADDRESS ,/A 2 4 P73 Parcel Number Lot Zoning Project Tvpe. Brief Description. Check all that apply New Construction Addition Remodel Repair Demolition Re -roof Heat System Other Floor Areas Basement 1 Floor 2 Floor 3 Floor Garage Carport Covered Porch Deck Shed Other BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn Building Permit Technician 321 E. Fifth St. Port Angeles WA 98362 (360) 417 -4815 fax (360) 417 -4711 House garage other tear off re -roof lay over one layer 'Heat pump wood- burning stove_ gas fireplace ,o. pellet stove other Total footprint of structures Site Coverage the amount of impe and other impervious surfaces (see P Max. height of proposed structure Will a lawn sprinkler system b- stalled? Will a fire sprinkler system b- installed? Existing (sq. ft.) P ft.) o Residential Multi family Occupancy group Occupant load onstruction type Phone Phone Phone if 60 -2_3 vi E -mail G es t Qc, Commercial Industrial C0.y e2eZ2 TOTAL VALUATION 600 s Lot size sq. ft. uotr rag<; ace on a parcel including structures, p. ed drive .ys, sidewalks. patios 7 94 135 for exemptions) Site. coverage I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand that�it is my responsibility to determine what permits are regy d, and to obtain permits prior to,wy nc on mojects. r ki,i ii rte/ Date 1 z� Print Name T Forms /Building Division /Bldg Permit.doc For City Use Only: Received C1- Z--09 Permit O9- qt 8 Date Approved per sq ft. of bedrooms full baths of h baths GA) of.ORT;,... (i ~ BUILDING PERMIT CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 ISSUED: 9/09/2002 PROPERTY LOCATION 216 5TH ST E Lot: 5 Block: 200 Subdivision: TPA Parcel No: 063000020020000 S: ARCHITECT N/A PERMIT NO: 13701 OWNER/APPLICANT JOHN.& CONSUELO WHITE 216 E 5TH STREET Port Angeles, WA 98362 360/457-3917 T: CONTRACTOR J & J CONSTRUCTION 233 ALICE RD Port Angeles, WA 98363 3601457-1809 PROJECT INFO Project Value: $11.937.00 Project Type:. SIDING Occupancy Type: RESIDENTIAL Occupancy Group: Construction Type: Zoning Use:. , 98360-0000 360/000-0000 o Long Legal Commercial: Industrial: Garage: 9J '......,....;..; .f'.... SFD Units: SFD sa FT: o o o o o fl1..... MFD Units: MFD sa FT: o o V)~ --h .s PROJECT NOTES INSTALL HARDY PLANK SIDING RECEIPT#9671 FEES ASSESSMENT Building Permit: Plan Check: . State Surcharge: ..... House Moving: Manufactured Home: Sign: Plumbing: Mechanical: Radon: $293.25 $0.00 $4.50 $0.00 $0.00 $0.00 $0.00 > $0.00 $0.00 Misc Fee 1: Misc Fee 2: Misc Fee 3: $0.00 $0.00 $0.00 TOTAL FEE: AMOUNT PAID: BALANCE DUE: $297.75 $297.75 $0.00 Separate Permits are required for electrical work, SEPA. Shoreline. ESA, utilities. private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days. if construction or work is suspended or abandoned for a period of 180 days after the work as commenced. or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Owner (if owner is builder) ~ Signature of Contractor or Authorized Agent Date T:\PLANNING\FORMS\1102.15 [4(2002) I' ~" I i [ -"1 I' J7()) .' ..). f~ _ ..~! CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE., iT IS UNp1. WFULTOCdmR, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN ACONSPICUOUS LOCA TI(fN: 1 I ':; t I -.-;~-< , :;j~;;}t~ :10'..,' '~F/;'2r BUll.DING PERMIT INSPECTION RECORD KEEP PERMIT cARD AND 'APPROVED PLANS AT JOB SITE ~'ii!.,:-:t yj: ; ~:;"- DATE ACCEPTED I YES I NO CO}\fMENTS' , ~ " ~' , (, ," . < . "''!~i'-j ,'f,' INSPECTION TYPE ", ;'jl, FOUNDATION: FOOTINGS , WALLS ,.' , .;;, FOUNDATION DRAINAGEi:,i{~S.JOi;(!O' . ,<, .. I . , I r ,'1:. ..' \- . . ''', . -;' ; L , . .;;: , ELECTRICAL (LIGHT DEP1) SEPARATE PERMIT:,# ROUGH-IN ,;,oj PLUMBING';', : ; ~ i UNDER FLOOR I SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW I WATER AIR SEAL WALLS CEILING FRAMING . JOISTS I GIRDERS SHEAR WALL WALLS I ROOF'! CEILING DRYWALL T-BAR INSULATION SLAB WALL I FLOOR I CEILING MECHANICAL HEAT PUMP. "; WOOD STOVE! PELLET I CHIMNE.;'i; HOOD I DUCTS , ',ii <y., PW UTILITIES I SITE WORK (EngineCring Division) SEPARATE PERMIT #'s: , '. , " '. ' .ii:' .'.', , -4-' : . '~)~, " ''','' ... ......." , r W ATERLINEI METER SEWER CONNECTION SANITARY STORM .~ ".:: ~ , . . ".,' .' .",' ;: . .. ii. " , '" ./, , d" ". :,' PLANNING DEPT. SEPARATE PERMIT #'s P ARKlNGILIGHTING LANDSCAPING . SEPA: ESA: SHORELINE: , ,f' , , RESIDENTIAL ," ii. F!NAL,~SPy:pONS RJi:QUlREi) PRIOR TO OCCUP~<;Y.1Y~E.". ""', ," , DAIJ'E" YES NO cq~l'tfERCIAL, '" . ..,Pt', ,",r.y.'"et ,', 417-4735 I '" "'i. ittEtTIUCAL' '[fl' ,2, LIGHT'DEPT' -:;0; ,.". ,..' . QATE,) ,. ,ACCEPTEQ' ',YEs NO' '1"" , ELECTRiCAL,~ ,LIGHT DEPT. ., .., .<,0 ... ,. , . . .. ,::" CONSTRUCTION R. W.I PWI ENGINEERING . , '" " , , -..,!.: ,:c....,<~...),,<..". .,: :' . ','._,~.' CONSTRUCTION - R. W. PW I ENGINEERING ," . 417-4807 EIRE, .'\ \..... PLANNJi.lci DEPi ' BUILDING 417-4653 :' ,c-. 417-4750 ~~1 .' ~ 417-4815 r"", ", KJ/ , ,- FIRE DEPT. ,. '".-' .. .. ,,' PLANNINqpEPT."",.,;." I: ,;" ,,'I i," \ BUILDING ' " . , , T:\PLANNING\FORMS\1102.15 [412002] " /" '.- s. .~' \ I \ \ , ;g Overhead o Underground / ,//'0 Voltage /.;zo /~~ ~10 03.0 Service size _7~{) Amps o Temporary ELECTRICAL PERMIT DATE I 02J'J'~ /0/3/90 ; / CITY OF PORT ANGELES LIGHT DEPARTMENT PERMIT NO. ~READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Site Address: Installed By: Owner/Business: Phone: Sq. Ft. OwnerfBusiness Address: A Residential Heat KW o Baseboard 0 Furnace/Boiler o Heatpump 0 Other o Commercial/Industrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) 1! New Construction o Remodel o Service update/alter/repair o Add/alter circuits o Auxiliary power (list below) o Special equipment (list below) DetailslDescription: ~~ --(Pes/cI~u ) ~ KIS/'-" 0 ( ~f) Ay J-L+ - ~14d5 Jk- f-- ~(J;y./' /11. . , MO~) J{) fu; ~~o ~ ;)Kc<} (<1I./J.Ut'r.-f r/tu'f W.S. No. Service Capacity: 0 O.K. 0 Not O.K. \ 0 Ditch inspection O.K. ~Rough'in/cover O.K. \ O.K. to connect service M Final O.K. \ Date Hold for: 0 Easement 0 Letter Size Comments o Signed up for service/meter o Meter Department notified for installation o Fire Department notified of inspection o Plan Review approved/pending Site Address: Permit/Receipt No. ,-,9 Lt S ~8~ ~:1 Installer: New Meters Date: \ Notify the De~meS of City Light by Street Addre~s and Permit Number when ready for~spection~work must not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Ins~ctor in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224. \ ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT " , I~ Inspector Amount paid VHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall ,YMI"IC PRINTERS, INC.