HomeMy WebLinkAbout1420 E 3rd St - Building
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FEE RECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
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..... . PERMITNUMBER
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TOTAL FEE
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caNT. Lie. NO. TIME TO COMPLETE
NO. STORIES
LEGAL OCCUPANCY
Site Address
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. PERMITS WITH WRONG ADDRESSES ARE CANCELLED
Owner
Owner's Address ~~.Ad _./j .
Day Phone tf:o.'7 - ?1S(?
Application is hereby made for Permit to i~all Electrical Equipment 85 follows:
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Installation By
Installers Address
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Installers Phone
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Wiring Method
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NUMBER AMP
USE OF CIRCUIT PEA
CIRCUITS CIA
LIGHT I
LIGHT
CONVENIENCE I
CONVENIENCE
APPLIANCE
DISHWASHER
DISPOSAL
.~ RANGE
OVEN
WATER HEATER
LAUNDRY
DRYER
FURNACE
GAS - Oil"
FURNACE
ELECTRIC
ELECTRIC HEAT
ELECTRIC HEAT
A.C. UNIT
FEEDER
SERVICE
120V
'"
240V
100R
30
\ SIGN
. I 50 VOLTS
OR LESS
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USE OF CIRCUIT
NUMBER
CIRCUITS
AMP
PEA
CIA
~A/
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240V /
100R
30
FEE
FEE
120V
10
,
MOTOR
MOTOR
FIRE ALARMS
BURGLAR ALARM
MISC.
I SUB-TOTAL
REINSTALLATION LIGHT FIXTURE #
SUB TOTAL FEE
ENERGY FEE
BASIC FEE
TOTAL FEE
SIZE OF SERVI\SWITCH ORj:IRCUIT BREAKER
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SIZE OF SERVIC~TRANCE CONDUCTORS
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SIZE OF GROUND / SIZE OF ~NTRANCE SWITCH
PHASE
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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
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Date Applic~tion made
. Date Permit Issued
(OR AUTHOR ED AGENT)
Permission is hereby given to do the above described work, according to the conditions hereon and accor ing to the approved plans and
specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles. !.. ~ \ .1 ,(
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PLA A PROVED : . ~ . ',_
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 inspection and O.K. for covering or service has been given by Inspector in
Writing on Permit Placard. A.. Permits Phone: 457.0411 Ext. 158.
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WARNING
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
WHITE - Original CANARY - Duplicate PINK - Triplicate WHITE CARD - Inspector's Report
OLYMPIC PRINTERS, INC.
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REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
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O.K. TO_CONNECT SERVICE
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2- 'IS- FINAL O.K. .
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CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N~
17678
/,;')-36 F/
Port Angeles, Washlngton..m......:oom......._..m.....oo..oommm...moom, 19,0000000
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 do electrical work as listed below.
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Address .mm...oo...m.moomoomm..oo..moo.m.m.;I2m..........oo....moom. OccupancYoo...m..mmoo.:mmoooo..._m.moo....
Owner c:..;."-<<'d"7.--;~~f..~-:=moo'~.m.(:;.0 ~J'enant.m...oo...moooooo_oooooom._mmoooommoo.oo....m....,......
Wiring ~~:~::~o~':.,.d~.r:f:f?0..~::.m By.oooo.........oom.m__.__m.__oo__.__moo..oo..mooomoo....m
/::YCJ/;,;J;Y(/
Light Outlets..............................._.._..... Service, volts ............7........................ Type of Wiring:
Receptacle Outlets...............................
No. wires .....................__.n......n...n
Dryer, KW un......n..__...........____.....n....
Range, KWm.hmmm__u.m....
Water Heater:
Size wlres..................................._..
Main fuse ....n.......n........................
Enclosure ...nn........n....n
Heat~:~.~~:~i/~~~~.?~::?i:~;.~~:~~~;t,~ l,~:r:~::n~~ble .............................
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Motors: size, volts and phase: Rigid Conduit .................
MetalUc Tubing .........__................
Current transformers:
No. & Size..nn......n.........................
Ser. NO...................................n.....n...
Ser. No. .................................nnnn....
Ser. NO..........................................n...
Armored Cable .......n....................
Non.Metalllc ......h....m..hh....h.h.h
Knob & Tube................................_
Rigid Conduit ....mmhh.mm.hhh...
MetalUc Tubing ..............nm...n...
Raceway ..............................._......_
Circuits. LighL.....n............m................
Utility hhhh......hhUUh...h.......h.......
Heat ......................................._......
Range n......n......n....n......n.............
Water Heater ...............................
Motor ........n..............nn.................
Dryer..................................................
Furnace .........................'~.nn._.n..n....
Total lAladn.n..nn...n............. Ser. No. .n......n......_........................n Total.......................................
Remarks: ....__mec..,t24..moo.!.?..~~.fk.--:C.oo~oo...,d-'0:L~:===.'?:=oom..mmm.mmm.m.oooo...__.m....m
..m.mmoommm...m.......moom..mm~m..m.__.....m.oooo.oolmmmm.______...__..mmm....m....mmm...oo..m.mm..m.mmoo...oo
Permit Fee
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$:oo.m........mmmoom.moooo.
Treas. Receipt
No..__..,...__.................
By ."J(!&;!!..~~.<.!:.~.
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con-
cealed due noUce 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~ 1 7 6 7 8
Address..................._.................................................................................._...............................Date..._......_.._.._.._.........._......_......_.........
Owner n....................n..n......_.........._...n._......_.._.....................................n..nn.....hn..... Tenant........nnn..nnn.....................nn....nn..nn.n....
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Wiring Contractor...................................... ....................................................................................By..............................................................
NOTICE-Current must not be turned on until Certificate ot Inspection has been Issued. It work Is to be con-
cealed due noUce must be given the Inspector so that work may be inspected before concealment.
1M Olympic Printers. Inc.
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