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Home My WebLink About309 W 6th St - BuildingPREPARED 3/21/11 8 21 04 INSPECTION TICKET PAGE 7 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/21/11 ADDRESS 309 W 6TH ST SUBDIV CONTRACTOR DAVE S HTG COOLING SRVC INC PHONE (360) 452 0939 OWNER SCOTT JUDITH ANN PHONE PARCEL 06 30 00 0 0 9360 0000 APPL NUMBER 11 00000208 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME99 01 3/21/11 JJ,L MECHANICAL FINAL TIME 01 00 March 16 2011 3 09 02 PM 1pangrle 1- (DAVE S HTG 452 0939) MECHANICAL FINAL HEAT PUMP AFTERNOON COMMENTS AND NOTES Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc Ductless heaat pump Owner SCOTT JUDITH ANN 309 W 6TH ST PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty 1 00 1 00 Unit Charge 73 5000 2 6000 Fee summary Charged Permit Fee Total Plan Check Total Grand Total WA 983625901 ELECTRICAL ALTER RESIDENTIAL 182501 76 10 3/15/11 9/11/11 Per ECH ECH 76 10 00 76 10 Signature of owner or Electrical Contractor X G• \EXCHANGE \BUILDING ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 11 00000225 812700 309 W 6TH ST 06 30 00 0 0 9360 0000 ELECTRICAL ONLY RESIDENTIAL HIGH DENSITY 0 Contractor EXTRA MILE TECH ELECT LLC 418 N RACE ST PORT ANGELES WA 98362 (360) 457 0198 76 10 00 76 10 Plan Check Fee Valuation EL BRANCH CIRCUIT WO /FEEDER EL ECH ADDNT BRANCH CIRCUIT Paid Credited INSPECTION TYPE DATE. DITCH SERVICE ROUGH IN FINAL COMMENTS PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION 00 00 00 Date 3/21/11 RESULTS 0 0 0 Extension 73 50 2 60 Due 00 00 00 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR. Date: Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc T stat 2 5 ton heat pump Owner SCOTT JUDITH ANN 309 W 6TH ST PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge Per 1 00 Fee summar' Permit Fee Total Plan Check Total Grand Total WA 983625901 ELECTRICAL ALTER RESIDENTIAL 182295 56 00 3/10/11 9/06/11 56 0000 ECH EL Charged 56 00 00 56 00 Signature of owner or Electrical Contractor X G \EXCHANGE \BUILDING ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 11 00000211 782650 309 W 6TH ST 06 30 00 0 0 9360 0000 ELECTRICAL ONLY RESIDENTIAL HIGH DENSITY 0 Contractor LVT THERMOSTAT DAVE S HTG COOLING SRVC INC PO BOX 413 PORT ANGELES WA 98362 (360) 452 0939 Plan Check Fee Valuation Paid Credited 56 00 00 56 00 INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION 00 00 00 Date 3/21/11 RESULTS 00 0 Extension 56 00 Due 00 00 00 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR. Date: MAR -13 -2011 06 32 PM E JANSSEN Cltyy of Port Angeles Permit Application Building DlvleionSElectrlcal In,Pecton, 321 Ent Plfth Street P,0. Box 1150 Port Angela, Woehington, 66302 Ph; (360) 417-4735 Fsx;1360) 4.7.4711 Dote .1 8 2 Single Family Dwelling Multi -Family or Commercial' Commercial Addition Alteration Remoc I Rev r' Plan Review May Bo Required, Please Corn;/Ia'o Electrical Plan feytew information Sheet .10b Address ?,Q9 4;;� __sir 3uilding Square Footage. NfLw, r�< !d■ 4 r of 3dove Unit Qharoo 5119 90 5 14550 5 204 80 S 202.20 5 37) 50 5 2 60 5 7350 5 7 60 S 92 70 5 110 30 S 148 70 5 167.90 555.90 5 88.20 5 95.90 S 63 90 S 63.00 5 119.90 5 102.30 5 110 5 3520 5 73 50 5110.30 S 5600 x e;,/,,Af (.J the b v> ..:k Date: f 360 RECE �E' MAR 1 1 2011 ELECTRICAL INSPECTIONS 0 Credit Card* 452 2982 P 01 Owner Information Cogntractor Information Mailing Name. Name. eX fd M 7-071. i f. C Eel IQ I C(� Mailing Address: 1 ■4 j� .Ct_E S4__ City' Stale. 44/A z.i� 9..0.6 3 City _E State b/_ A !ip 4 1 sr 31 Z Phone. Fax: Phone..}' ,7 .,.Fax X.4'-C License 1 I Exp 1. cense I Exp T /3 6 12...<1 r r Total 101v Multiplied by Unit Charael Service/Feeder 200 Amp. Sotviceo-eedor 201.400 Amp r Service/Feeder 401 -600 Amp Service /Feeder 601.1000 Amp Sonncen -ceder over 1000 Amp. Branch Circuit W/ Service Feeder Branch Circuit W/O Service Feeder .G Each Additional Branch Circuit Tomo Service/ Feeder 200 Amp. romp Service/Feeder 201 -400 Amp. Temp Service/Feeder 401.600 Amp Tamp Service /Feeder 801 -1000 Arm Portal to Portal Hourly Sign /Outline Lighting Signal Circuit/Limited Energy Commercial. Additional •20 Signal CircuiU Limited Energy 1 2 Family Dwelling Signal Circuit Limited Energy Multi Family Dwelling ManulaClured Home Connection Renewable Fiectrlcal Energy 5KVA System Of Lesn First 1300 Square Fl. Each Additional 500 Square Ft. or Porvor of Fvrh Outbuilding or Detached Garage Each Swimming Pool or Not Tub Thermostat 5 1.4 Total /1. Owner as do4nod by RCW,1112e.201: (1) Owner wd1 occupy Inc structure for two years after this electrical permit is ftnal/zoo ixi Owner is required to hire an electrical contractor it above said properly la for silo, rent or lease. Permit expires after six months 01 tan inspection. Alter reeding the above statement, a hereby certify that I am the owner of the above named property or a licensed electrlcat comrector rem making the electrical Installation or alteration In compliance with Inc electrical lews,1J.E.C. RCW. Chapter 13.28, WAC. Chapter 296.466, The City of Port Angelo* Municipal Coda. and Utility Specifications, Signature of owner. electrical controctor or electneal administrate: I1 cash Date Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc HEAT PUMP Owner SCOTT JUDITH ANN 309 W 6TH ST PORT ANGELES CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Permit MECHANICAL Additional desc HEAT PUMP Permit pin number 182253 Permit Fee 64 80 Issue Date 3/10/11 Expiration Date 9/06/11 Qty Unit Charge 1 00 Fee summary Permit Fee Total Plan Check Total Grand Total 14 8000 EA T Forms /Building Division /Building Permit WA 983625901 Per Charged 64 80 00 64 80 3//0/% )1,0//'ar:// 11 00000208 086528 309 W 6TH ST 06 30 00 0 0 9360 0000 MECHANICAL APPL PERMIT RESIDENTIAL HIGH DENSITY 6990 PERMIT Contractor DAVE S HTG COOLING SRVC INC PO BOX 413 PORT ANGELES WA 98362 (360) 452 0939 Plan Check Fee Valuation BASE FEE ME FURN /HP /FAU OR 5 TON Paid Credited 64 80 00 64 80 00 00 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 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 performance of construction Print Name Signature of Contractor or Authorized Agent Date 3/10/11 0 0 0 Extension 50 00 14 80 Due 00 00 00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) Signature of Owner (if owner is builder) BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 4815 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 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 Date Accepted By Comments FOUNDATION Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs PLUMBING Under Floor 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 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 1 ESA. Landscaping 1 SHORELINE. T•Forms /Building Division /Building Permit FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Electrical 417 -4735 Construction R W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 FINAL Date Accepted by 3- FINAL Date Accepted by Date Accepted By Mar 09 11 10'07a Dave s Heating Cooling City of Port Angeles Permit Application Building DivisionlElectrical Inspections 321 East Fifth Street -P.O. Box 1150 Pori Angeles Washington, 93362 Ph: (360)417-4735 Fax: (360) 417 -4711 Date: 3( t i tS 1 2 Single Family Dwelling Multi -Family or Commercial Commercial Addition 1 Alteration 1 Remodel I Repair Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: 30 Ge3- e-5-1 G, Budding Square Footage: 1 -5 o O Description of above Ihsfia.(( fi o aG j QC v�c s�,s4 n Owner Information Name' c iA. 5C- c 4{ Mailing ddress: 3 W.t 1 O'/ 5 6 F►�..4 City yO r-i- r tote: l..r1A Zip 6 1W ..3G2 Phone: 7Fax: License A/ Exn Unit Charoe 119.90 5145.50 5 204.60 5 262.20 372.50 2.60 73.50 2.60 5 92.70 110.30 148.70 5167.90 95.90 86.20 5 95.90 63.90 63.90 5119.90 5102.30 5110.30 35.20 73.50 5110.30 556.00 5 5 s 5 5 5 S 5 5 s 5 5 5 5 SG, GoTotaI heck X r Date: 3 (if g Credit Card 3604520939 ECE MAR 9 7011 ELECTRICAL INSPECTIONS Contractor Information Name: ,D acv a 1 roe R H v %fti. MailingAddress' 4 C FQIr 3 City State: c:A 3p: Phone:, 5 i�`�. Fax: �S�- 0939' License /Exp. ,DAVE5 NGc79 f QC_ Total fOty Multiplied by Unit Charoe) Service/Feeder 200 Amp. Service/Feeder 201 -400 Amp. Service/Feeder 401 -600 Amp. Service/Feeder 601 -1000 Amp. Service/Feeder over 1000 Amp. Branch CircuitW/ Service Feeder Branch Circuit W/O Service Feeder Each Additional Branch Circuit Temp. Ser icel Feeder 2C0Arno Temp. ServicelFeeder 201 -400 Amp. Temp. Service/Feeder 401.600 Amp. Temp. ServicelFeeder 601 -1000 Amp. Portal to Portal Hourly SigniOutine Lighting Signal Circuit/ Limited Energy Commercial. Additional 1500 $5.00 Signal Circuiti Limited Energy 1 2 Family Dwelling Signal Circuit/ Limited Energy Mud-Family Dwelling Manufactured Home Connection Renewable Elec tncal Energy SKVA System or Less First 1300 Square FL Each Additional 500 Square R. or Porten of Each Outbuilding or Detached Garage Each Swimming Pool or Hot Tub J 6.. 00 Thermostat ai ED rip:a.Ntoofts..- Signature of owner, electrical contractor or electrical administrator Cash p Owner as defined by RCW.19.28.261. (f) Owner will occupy the structure for two years alter 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, t hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electricat installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296468, The City of Port Angeles Municipal Code, and Utility Specifications. Mar 09 11 09 47a Date g Parcel Number Dave s Heating Cooling Max. height of proposed structures Will a lawn sprinkler system be installed? Will a fire sprinkler system be installed? T;Fornseuiiding DivisionFHldg PermiLdoc BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn: Building Permit Technician 321 E. Fifth SL, Port Angeles, WA 98362 (360) 417 -4815 fax (360) 417 -4711 Applicant s Phone Property Owner r Phone Property Owner's Address u 3O 9 C=A- Contractor ,Dave`s I-(.e Phone Contractor's Address P. o buk Q 2, r,GQk s License :DA UE t KC- Expires 5/I /tea r l E -mail PROJECT ADDRESS 3 LJe-s -t S r proiect Tyree Brief Description: residential o Multi- family o Commercial Check all that apply New Construction o Addition o Remodel a Repair o Demolition c Re -roof 6 Heat System o Other o House garage other o tear off re -roof o lay over one layer Heat pump o wood burning stove o gas fireplace o pellet stove o other Floor Areas Existing (sq. ft.) Proposed (s4. ft) Basement per sq. ft. 1 Floor 2 Floor 3 l Floor Garage Carport Covered Porch Deck Shed Other Total footprint of structures sq. ft. Lot size sq. ft. Lot coverage Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios, and other impervious surfaces. (see PAMC 17.94 135 for exemptions) Site coverage ft. 11 Print Name _TT 0 (cater' Occupancy group Occupant load Construction type TOTAL VALUATION (o. 91 D 1 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 required, and to obtain permits prior to wpriking on projects. Signature 3604520939 p1 Lot For City Use Only Date Received -ci -t Permit# 4 Date Approved 4 67 C r S'3 Zoning of bedrooms of full baths of half baths Industrial ~ ~ORT ~ ~.O~\, c}r.~ L~ ~ "l.Oi:1C~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Lasereo CED G .....::! Appl~cation Number Applicat~on p~n number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Applicat~on type descr~pt~on Subdiv~s~on Name Property Use Property Zoning . . . Application valuat~on 07-00000249 Date 3/09/07 059641 309 W 6TH ST 06-30-00-0-0-9360-0000- JUDY SCOTT RE-ROOF ~ .;+- ~ Owner Contractor f, <1A-[~ J :? }~/O) RESIDENTIAL HIGH DENSITY 715 SCOTT JUDITH ANN' 309 W 6TH ST PORT ANGELES WA 983625901 WES~O ENTERPRISES PO BOX 1527 PORT ANGELES (360) 452-1430 WA 98362 Perm~t BUILDING PERMIT - NO PR FEE Additional desc TEAR-OFF, FELT, COMP RESHEET Perm~t pin number 97014 Perm~t Fee 59.15 Plan Check Fee .00 Issue Date 3/09/07 Valuation 715 Exp~rat~on Date 9/05/07 Qty Unit Charge Per Extens~on BASE FEE 50.00 3.00 3.0500 HND BL-501-2K (3 . 05 PER C) 9.15 Other Fees STATE SURCHARGE 4.50 ~ ~ ~ Fee summary Charged Paid Cred~ted Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 59.15 59.15 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 63.65 63.65 .00 .00 ~ ~ :1 ~ ~ 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 penod 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. () J~O?-O? Date Signature of Owner (If owner IS bUIlder) Date T \Pohcles\II02_15 bUlldmg penmt InspectIOn record05 wpd [1/4/2005] BUILDING PERMIT INSPECTION RECORD ~ -3 , ~ ..;r: --C CALL417-4815 FOR BUILDlNG INSPECTIONS CALL 417-4735 FOR ELECTRICAL INSPECTlONS. CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, JNSULATE OR CONCEAL ANI' WORK BEFORE INSPECTED AND A CCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YE~ NO FOUNDATION FOOTINGS SHEAR WALLS 1 WALLS FOUNDATION DRAINAGE 1 DOWN SPOUTS PIERS I POST HOLES (POLE BLDGS ) PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN , WATER LINE (METER TO BLDG) GAS LlNE FlNAL DATE ACCEPTED BY BACK FLOW I WATER AIR StAL WALLS CEIUNG I FRAMING JOISTS 1 GIRDERS SHEAR W ALL/HOLD DOWNS WALLS I ROOF 1 CETLlNG DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I MECHANICAL ROUGH-IN HEATP~JFURNACE/DUCTS GAS LINE FlNAL DATE ACCEPTED BY WOOD STOVE 1 PELLET 1 CHIMNEY MANUFACTURED HOMES FOOTING 1 SLAB BLOCKING & HOLD DOWNS SKJRTING PLANNING DEPT SEP ARA TE PERMIT #' s SEPA P ARKING/LIGHTING ESA LANDSCAPING SHORELINE FINAL INSPECTIONS REQUTRED PRIOR TO OCCUPANCYfUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTIONR W IPWI /1 . CONSTRUCTION - R W ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 4] 7-4653 / / 1/ FIRE DEPT PLANNING DEPT 417-4750 I j PLANNING DEPT BUILDING 417-4815 ?. .1Ja./ t) 'I 4!, /\,f BUILDING T IPol,elesl] 102 15 bmldmg pemll1 mspecllOn record05 wpd [1/4/2005] J \ ~ ~ ~ ~ ~ J: PREPARED 3/12/07, 11 17-58 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE ~ 11 3/12/07 ADDRESS TENANT, NBR CONTRACTOR OWNER PARCEL _ _ APPL NUMBER 309 W 6TH ST JUDY SCOTT WESCO ENTERPRISES SCOTT JUDITH ANN 06-30-00-0-0-9360-0000- 07-00000249 RE-ROOF SUBDIV PHONE PHONE (360) 452-1430 PERMIT: BNOP 00 BUILDING PERMIT - NO PR FEE REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ~~;;-~~----;/~/~;---tl?--~-- ----~~~~~~~~:~~~~~-::;~~--~~:~~::---------------------------------- _ KERRY 452-1430 PERMIT IN WOOD SHED / ~asered CED COMMENTS AND NOTES WTJu(} Sh-eJ out )' GI#5V~b ~ {VL A/vr S+r?vJwV6J- ll'6f PW- of TH:c ~:-j r ' . ~ ".. .r,''''r;~~i'''U''''1:^\ , ; I I 1 I j. , , !:~.;;.,,,,'-~ I' Laden:. CED ~ . , . r ': ,,\ ,- ~:f:, I I I J, I f , J~)y 501' """k . ,q-:'-JI 1>-1 ' I,. t r j .if, '1'1 ,I!!. . ,j , I f \11,:\\~.~~.- ".~~. \,. '{.:~ ~ ~,,' 1. H .::.:;,:..~' ~ 'I d -1 j " ~ ~ .< :) , .1 , "; Ii , ~l " 5'~11I- w 6 f-I, :..u ',//7-22 V7 fJ "7 -6'7 J..s<? J'!~I eM Iy I J>I 2:?z. 700 'I~ a; ijoo - r ~ /.Ie Jrh t:- fq / c/ car J hry "l~" '~1 i 4 I :1 VF~ i~ , . 50' - ..- 2-.S ~ >C>- -f~ ~ a /'VI rve-/ - ~/;il~ r "., 1-2.0 - ~~ f /'c-r~1" ( lax " 4'!:L- 77r ".p 100 - '7 ?..s- ~~ ~c 'd4); Ij {;I ;1 ;i - " . ":' , / CITY Of PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N? 16253 Port Angeles, washlngton.........___..2.:::...~....__..._..._....______.___. 19..(}?> In accordance with the City Ordinance to regulate the installation, extension, or repair of elec- trical equipment in, on, or about any building or other structure in the City of Port Angeles, per- mission is hereby granted to d6 electrical work as listed below. Address __n_:?_.Q_.~.4?:__~~""'J;.._.nmnnnm........_ occupancy__-r'...I!..~..._..._____n......__...m Owner __...~~..J:...Le..__.___.._._._n__';t-.-:.::.._ TenanL........_.m............._..._.........._......__....._____.......... .-v - ,....,v Wiring Contractor ....__c....__.__..................._...............m............ By.__n___.______....__._._n.__.__m.........__.__........__.._...._.. Light Outlet...................._.......__________... Service, volts ...............d....__................ No. wires __...______..__.__..................... Receptacle Outlets............................... Dryer, KW..............................._......__.. Size wires___.....___...n___................_.. Range, KW....___.___.hh.._____..___. Main fuse __n....h..___......................__ Water Heater: Enclosure __....h.....m........_____.......... KW.--...-..mn..m-:mg,-....i'i"'.. Hea', Kw-.,;J-;?!..:[;?'!..,f.-!.---f:qr Type of wiring: Entrance Cable ............m....... Motors: size, volts and phase: Rigid Conduit ....m___...__.....h Metallic Tubing ....0....._...... Current transformers; No. & Size.....__.....__..........h............. Ser. No............____....__........................ Ser. No.__........__................................. Ser. NO........__...__.....................h.......__ Total Load____.....__.................. Ser. No. ...........................0.....__.__.__..__ Type of Wiring: Armored Cable .............................. Non-Metallic .__.......___.........h....hh_ Knob & Tube.......................__......._ Rigid Conduit ..._.....,...................._ Metallic TUbing ..__...........___.......__ Raceway ......................................._ CIrcuits, Light................___.................... Utillty...._.__.....___........_..._...______...... I-Ieat ............................................... Range ............................................. Water Heater ....___h___................... Motor ..........__................______......h... Dryer...........__..__..........____.........__.__..._ Furnace .........................._.____..........__.. ., Remarks: __m.n_.................n_n___n_..n__..........._......._...............__nm_nmm...m_........._..........._..........._....._.__....._..__.. Total....................................... _;:;;;;;~.;::mmm.._m__.......m..;~:~~...~:~:;~~.........-.....-m-m---n..---.......;~~-~:.a-..--..2n-......- $:............_.._______....._......... No.__..._____...._......_....._ By _~"..~-....:it.-/.d'!'.,-....-~~-..;j./..~:,-'-'": NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con- cealed due notice must be given the Inspector so that work may be inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT N? 16253 Address...............:........................................................................................................................Date..._.........._.................._......_......_......... Owner ........0.__.....0..____....0......_.........._.................._.........____........__............................____.... Tenant.....__.____________.____...__..__......__.........____...........__ Wiring Contractor....................................... ...................._.............................................................By.............................................................. NOTICE-Current must not, be turned on until CertifIcate of Inspection has been issued. If work is to be con- cealed due notice must be given the Inspector so that work may be inspected before concealment. ., ~ \