HomeMy WebLinkAbout112 1/2 E 1st St - Building
!.~EC~ ~MBER
CITY OF PORl: ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
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PERMIT NUMBER
.
TOTAL FEE
/~~.
! 2-//' ELECTRICAL PERMIT ONLY
J./171/ [. I S7
CORR C ADDRt,SS IS RESPONSIBILITY OF APPLICANT
CONT. Lie. NO.
TIMETOCOMPLETE
NO. STORIES
LEGAL OCCUPANCY
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Site Address
Owner
It.
PERMITS WITH WRONG ~DRESpES ARE ~NCELL~ .i '
Installation By bs!1?s cl..EC rrt.tC
Installers Address
Owner's Address
Day Phone Installers Phone
Application is hereby made for Permit to install Electric~1 Equipment asJollows:
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U HI--r-
Wiring Method
..
NUMBER AMP 120V 240V NUMBER AMP 120V 240V
USE OF CIRCUIT CIRCUITS PER 10 10QR FEE USE OF CIRCUIT CIRCUITS PER 10 100R FEE
CIR 30 CIR 30
LIGHT SIGN
LIGHT 50 VOLTS
OR LESS
CONVENIENCE MOTOR
CONVENIENCE MOTOR
APPLIANCE .. MOTOR .
DISHWASHER FIRE ALARMS .
DISPOSAL BURGLAR ALARM
RANGE MISC.
..
OVEN
WATER HEATER
.
LAUNDRY
DRYER REINSTALLATION LIGHT FIXTURE #
FURNACE SUB TOTAL FEE
GAS - OIL
FURNACE ENERGY FEE
ELECTRIC BASIC FEE
ELECTRIC HEAT .. - .
TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
- .
A.C. UNIT AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE AW.G.
-I SUB-TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH
I certify that the work to be performed under this permit will be done by the installer and in conformance with the N.E.C. Electrical Code.
Date Application made
, 19
By
CONTRACTOR OR OWNER (OR AUTHORIZED AGENT)
Permission is hereby given to do the above described work, according to the conditions hereon and according to the approved plans and
specifica'tions pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles. '. \,
DIRE OR i: n'Y'LIGHT \..
ell/117
.
Date Permit Issued
D
Notify Department of City light by Street Address and Permit Number when ready for inspection. Work must not
be covered or current turned on before inspecti9n and O.K. for cov~ring or service has been given by Inspector in
Writing on Permit Placard. A. - Permits Phone: 457-0411 Ext. 158.
WARNING
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
WHITE. Original CANARY. Duplicate PINK - Triplicate WHITE CARD -Inspector's Report
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REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
.-
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t / ("I In IlL cr O.K. FOR COVERING
, { , O.K. TO CONNECT SEAVICE
, FINAL. O.K. ,
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Oi/l0/2003 08:32
FAX 36045i4698
STRAITS ELECTRIC
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. _ ELEqRICAL PERMIT APPLlCATIOI\I
Rlll. OffiCiAl.. USE: ONLY
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The EleclricaI Permit Application must De (flied out comPletely.
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PI....... type or reprint In Ink. II you have any questions, p""'''' call (360. '17-4735
Fa>: number: (360) 417~11
stra-ts Electric
Owner or Elee. ConlraCtOT Agent .;.
Propeny Owner. ~ 75eJiger
Addreso: J 12 Y 2- f:, Rr'st
Electric
Phone'
REQUEST INSPECTION 0
452-9104 Far 457-4698
CIty:_Pcn- . Arvj)ts
license #: STRAIE* 0 bj,O S
~~ Port Angles, W~
:tJ ELECTRICAL CONTRACTOR
Phone:
Zip: q:a?(Q2
phooe.452-9104
Zip: 98362
Electrical c.,ntnl<:1O~ Straits
Address: P.O. Box 2914
.9/03
INSTAu.AllON WIRED BY: 0 OWNER
Credit Card Holder Name: Straits
Electric
Billing Address' P.O. "'ox 291 4
,
//6 t. j5.J.-
Zip: 98362
VISA~MC,-
o Residental
o Multi-family
~ -Commercial
~ AherationlAddition
o Mobile Home Sq. Ft.
TYPE OF WORK:
Check all that apply: 0 New
o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump 0 Low Voltage 0 Telecom. 0 Sign
Number of Circuils added or altered:
DESCRIPTION OFTHE ELECTRICAL PROJECT: Uf5fOdL 1D IIJrJA r;;!e 1VrLe.
Electrical Heat Load Additions
4' 'lc:, .~O
Service Infonnatlon
o Baseboard
o Fumace
o Heat Pump
o Fan.Wall
_KW
_KW
_KW
_KW
o Overt1ead Service
o Temp Service
o Underground l?e.....ice
Voltage:
Phase: 0 1 0 S
Service Size:
Feeder Size:
PAMC 14.05.060(8): For industrial, commercial, & residential projects larger lhan a duplex. a one -line drawing of !he Electrical Service &
Feeders, building size (sq. ft.), load calculations, and the type & of conductors and/or raceway is reQUired and shall acrompany the
Eleclrical Permit application.
I hereby certify that I have read and examined this applicatjon and know that same to be true and correct, and I am
authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits
are required; it remains the applicants responsibility to determine what permits are required and to obtain such.
Credit Card Holder's Signature:
er/Christie Tucker
Date:
7- 10-0