HomeMy WebLinkAbout1017 E 4th St - Building
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FEE RECEIPT NUMBER
CITY OF PORT ANGELES (
.. DEPARTMENT OF LiGHT
APPLICATION AND ELECTRICAL PERMIT
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PERMIT NUMBER
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TOTAL FEE
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CONT. LIe. NO.
TIMETO COMPLETE
NO. STORIES
LEGAL OCCUPANCY
Site Address
ELECTRICAL PERMIT QNL Y
E. to 17, . .
T ADDRESS IS RES ONSIBILlTY OF APPLICANT
.6,-. Co
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
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Owner
Owner's Address
Installation By
-. Installers Address
PERMITS WITH WRONG ADDRESSES ARE CANCELLED
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Day Phone Installers Phone
Application is hereby made for Permit to install Electrical Equip~ent as fOIIc::>ws:
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Wiring Method
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NUMBER AMP 120V 240V NUMBER AMP 120V 240V
. USE OF CIRCUIT PER 100R FEE USE OF CIRCUIT PER 100R FEE
CIRCUITS CIR 10 30 CIRCUITS CIR 10 30
LIGHT SIGN
50 VOLTS "
LIGHT OR LESS
CONVENIENCE MOTOR
CONVENIENCE I MOTOR
APPLIANCE I .J.-- MOTOR . ..
DISHWASHER t Iptr FIRE ALARMS
DISPOSAL , ~ ~ J 11.- LAR ,l((ARM
RANGE I. \tF 1/ MISC.
A
OVEN tv L-' 7
WATER HEATER ./
LAUNDRY 1/ ,. m
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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 9 It I if 19 By /'t t
'/ of. ", CiNTRACTOR OR OWNER (OR AUTHORIZED AGENT)
Permission is hereby given to dotre above d.escri!;>e.d work, aci'c6"rding to.the conditions hereon and according to the approved plans and
specifications pertaining thereto, subject to compliance with the Ordinanq~~.9J th.'E ..ity 9f Port Angel~s.
. .0 TO .cITY LI
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By
PLANS PRO
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 covertng or service has been g"iven by Inspector in
Writing on Permit Placard. A. - Permits Phone: 457.0411 Ext. 158.
.
Date Permit Issued
WARNING
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
WHITE. Original CANARY - Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
REPORT OF INSPECTOR
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DATE OF VISIT MWEfV REMARKS
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~//t 14(- '7/fF O.K. TO CONNECT SERVICE
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