HomeMy WebLinkAbout136 W 4th St - BuildingPREPARED 7/09/10 8 45 34 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 7/09/10
ADDRESS 136 W 4TH ST SUBDIV
TENANT NBA DAVID SONJA BROWN
CONTRACTOR AIR FLO HEATING CO INC PHONE (360) 683 3901
OWNER LLOYD W STRANDHOLM PHONE
PARCEL 06 30 00 0 0 8830 0000
APPL NUMBER 09 00000402 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99 01 7/09/10
MECHANICAL FINAL TIME 01 00
July 7 2010 9 44 53 AM 1pangrle
SONJA 360 460 6629
MECHANICAL FINAL HEAT PUMP
AFTERNOON
PLEASE CALL HER 30 MINUTES AHEAD SO SHE CAN MEET YOU THERE
COMMENTS AND NOTES
ELECTRICAL INSPECTION
WIRING REPORT
417 -4735
DATE PERMIT INSPECTOR
ti l40q ci -o -0LI N7
OWNER/COTVTRACTOR
4-t AM Tre- c
ADDRESS
7 t L) y sx
APPROVED NOT APPROVED
DITCH
ROUGH IN /COVER
SERVICE
FINAL
CORRECTIONS NEEDED' &re 1 R-D'M.CT PurrCg CL
+ms r_ NYC 7 LD•A
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
DO NOT REMOVE
OLYMPIC PRINTERS, INC. (360) 452 -1381
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
3 ton HP 10 KW furnace
Owner
Brown David
136 W 4th ST
PORT ANGELES
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Fee summary
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 98363
ELECTRICAL HEATPUMP
146795
57 50
5/26/09
11/22/09
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
09 00000494
910610
136 W 4TH ST
06 30 00 0 0 8830 0000
ELECTRICAL ONLY
RESIDENTIAL HIGH DENSITY
0
Contractor
SHAMP ELECTRICAL CONTRACTING
PO BOX 383
PORT ANGELES
(360) 452 1689
Qty Unit Charge Per
1 00 57 5000 ECH EL BRANCH CIRCUIT WO /FEEDER
Special Notes and Comments
May 26 2009 9 39 26 AM BANDERS Brian 417 4708 OK
Charged Paid Credited
Permit Fee Total 57 50 57 50 00
Plan Check Total 00 00 00
Grand Total 57 50 57 50 00
DATE.
Plan Check Fee
Valuation
Date 5/26/09
WA 98362
Due
RESULTS
712t h
7)2o hp
00
0
Extension
57 50
00
00
00
Signature of owner or Electrical Contractor X Date
INSPECTOR.
05/22/2009 14 04 FAX
City of Port Angeles Permit Application
Building DIvIslon /Electrical Inspections
321 East Fifth Street P.O. Box 1150
Port Angeles Washington, 98362
Ph: (360)417-4735 Fax: (360) 417.4711
Date 5 22-
1 2 Single Family Dwelling
Multi- Family or Comma
Commercial Addition
Remodel Repair'
RECEIVED
MAY 2 6 2009
LIGHT DEPT
Plan Review May Be Required Please Complete Electrical Plan Review Information Sheet
Job Address 3 4 l .s 115
Building Square Footage
DesCripuon of above P_ci itew `p adit
Signature of owner electrical contractor or electrical administrator
Cash
Check
-Oats: 5 Credit Card 1#
Owner Informatio Contractor Information
Name: D0.v� c1 134 Name: 5tuu.�0 G-t rk.
Mailing Address: 13 A (p tJ b 54 Mailing Address.
City State: t.). Zip: __4 t o 5 6 3 City O G t State: W A Zip A
Phone: 7 7 3y °10 Fax: Phone: 2 168't _Fax:
License 1. Exp License 4 Exp,
Unit Charge Q •1 Total tQtY Mulholied by Unjt ChArcej
93 75 Service /Feeder 200 Amp.
5113 75 Service /Feeder 201 -400 Amp.
$160 00 Service/Feeder 401-600 Amp
$205.00 Service/Feeder 601 -1000 Amp
529125 5 Service /Feeder over 1000 Amp
2 00 S Branch Circuit W/ Service Feeder
57 50 S'7 Branch Circuit W/O Service Feeder
2 00 5 Each Additional Branch Circuit
72 50 Temp Service/ Feeder 200 Amp
86 25 Temp Service /Feeder 201 -400 Amp
5116.25 Temp. Service /Feeder 401 -600 Amp
$131 25 Temp Service/Feeder 601 1000 Amp
75 00 Portal lo Portal Hourly
69 00 Sign /Outline Lighting
75 00 Signal Circuit/ Limited Energy Commercial
50 00 Signal CircuiV Limited Energy 1 2 Family Dwelling
5 50 00 Signal Circuit/ Limited Energy Multi-Family Dwelling
9375 Manufactured Home Connection
80 00 Renewable Electrical Energy 5KVA System or Less
,66 25 First 1300 Square Ft
27 50 Each Additional 500 Square Ft, or Portion of
57 50 Each Outbuilding or Detached Garage
5 66 25 Each Swimming Pool or Hot Tub
43 75 Thermostat
5-7e5= Total
I j 001 /002
Owner as defined by RCW.19,28.261 (1) Owner will occupy the structure for two years after this electrical permit is finalized, (2) Owner is required to hire an
electrical contractor if above said property is for sale, rem or lease.
After reading the above statement, I hereby certify that I am the owner of the above named property or licensed electrical contractor I am malting the electrical
installation or alteration in compliance with the electrical laws, N.E.C. RCW. Chapter 19,28, WAC. Chapter 296.468, The City of Port Angeles Municipal Code, and
Utility Specifications.
Application Number 09 00000402 Date 5/06/09
Application pin number 196834
Property Address 136 W 4TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 0 8830 0000
Tenant nbr name DAVID SONJA BROWN
Application type description MECHANICAL APPL PERMIT
Subdivision Name
Property Use
Property Zoning RESIDENTIAL HIGH DENSITY
Application valuation 14975
Application desc
INSTALL HEAT PUMP
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES WA 98362
Owner Contractor
LLOYD W STRANDHOLM AIR FLO HEATING CO INC
5205 NE SKIDMORE ST 221 W CEDAR
PORTLAND OR 972182153 SEQUIM WA 98382
(360) 683 3901
Permit MECHANICAL PERMIT
Additional desc INSTALL HEAT PUMP
Permit pin number 145391
Permit Fee 64 80 Plan Check Fee 00
Issue Date 5/06/09 Valuation 0
Expiration Date 11/02/09
Qty Unit Charge Per Extension
BASE FEE 50 00
1 00 14 8000 EA ME FURN /HP /FAU OR 5 TON 14 80
Fee summary Charged Paid Credited Due
Permit Fee Total 64 80 64 80 00 00
Plan Check Total 00 00 00 00
Grand Total 64 80 64 80 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 fora 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.
5 S Joy S►tt eA C
Date Print Name Signature of\ontractor or Authorized Agent Signature of Owner (if owner is builder)
T:FormsBuilding Division/Building Permit
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 Fumace 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 Date Accepted by
FINAL Date Accepted by
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
Date Accepted By
°7/09,
d
V v
E
per co ol`
v rORrq
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
hone call cd Sottj& 96 /o'?
Qe' P S VA lives 11ev"e ear'S.
So,4i 134.64A Phone 1 (2O
Owner's Address
Contractor /Engineer
Contractor /Engineer's Address tai
License
Applicant or Agent
Owner ki
PROJECT ADDRESS 13(Q %g
Parcel Number
Proiect Tvoe Brief Des
Check all that apply
CI New Construction
o Addition
Remodel
o Repair
Re roof
o Demolition
Sign
KH System
o Other
Floor Areas
Basement
i Floor
2 Floor
3'd Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
I d
So c).ec�5e.� �,-i1,e�r-
V/ h �aS Sa�15a r+•o i 5 5115r? d 54- 1- ahckt- okvv
Work S +rand holm 5205 NE SKdrnore. Pot -tl ar ,OR
.er f Icr n o tun< .c1 L►nrne a. Phone
�3(Q W. 144 tea ht4(9E 5 vJ
5 E 60 0A tiJ a.t3' 1
ftiit FLo IAS Phone _NA
k I R aifd Oi 1 Cie --i Expires
cription.
o Residential o Commercial
o wall- mounted o projecting o freestanding o awning o other
Total sign area sq. ft. Maximum allowed sign area sq ft.
KHeat pump o wood burning stove o gas fireplace pellet stove other
Existing (so. ft.) proposed (sg. ft.)
Total footprint of structures sq ft. Lot size
Max. height of proposed structures ft Occupancy group
Will a lawn sprinkler system be installed? Occupant Toad
Will a fire sprinkler system be installed? Construction type
ILSE C89 09E
o Multi family
For City Use Only
Date Received S 5-o?
Permit* 09- y 02
Date Approved
Poi t 44 E 1_E5 vJ
Lot Zoning
per sq ft.
o Industrial
TOTAL VALUATION !115
sq. ft. Lot coverage
of bedrooms
of full baths
of half baths
Ltsi 34.k9a
Pr
V3 =3901
have read and completed this application and know if to be true and correct. t am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are required, d to obtain prior to working on
projects.
Date Print Name L A&C..__E-1. Signatur -11�, gov■
T:Forms /Building Division /Bldg Permit Appl. -2006 Code.doc
01.d ?I I d WULE T T 6002 SO geW
1
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
3 ton Heat Pump 10 KW furnace
Owner
Brown David Sonya
136 west 4th street
PORT ANGELES WA 98362
(360) 457 3490
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per
1 00 43 7500 ECH EL LVT THERMOSTAT
Special Notes and Comments
May 7 2009 8 04 53 AM banders
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
cooz. i-LA ,l jL z
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
ELECTRICAL HEATPUMP
145417
43 75
5/07/09
11/03/09
Charged
43 75
00
43 75
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -4735
09 00000404
935708
136 W 4TH ST
06 30 00 0 0 8830 0000
ELECTRICAL ONLY
RESIDENTIAL HIGH DENSITY
0
Contractor
AIR FLO HEATING CO INC
221 W CEDAR
SEQUIM WA 98382
(360) 683 3901 6t3 3`. 11.
Plan Check Fee
Valuation
Brian 417 4708 OK
Paid Credited Due
43 75
00
43 75
00
00
00
DATE RESULTS
6/c/09 44
Date 5/07/09
00
00
00
00
0
Extension
43 75
Signature of owner or Electrical Contractor X Date
INSPECTOR.
P
City of Port Angeles Permit Application
Building Division /Electrical Inspections
321 East Fifth Street- P.O. Box 1150
Port Angeles Washington, 98362
Ph: (360) 417 -4735 Fax: (360) 4174711
Date: 5
11 2 Single Family Dwelling
Multi Family or Commercial'
Commercial Addition Alteration Remodel Repair'
Plan Review May Be Required, Rose Com_pjete Electrical Plan eview Information Sheet
Job Address: 1 Sr 1 P eed. Et-E5 W*
Building Square Footage:
3 n KG—)
Description of above A nD H i X19 r' P &u 442 N F C
Owner I fo ation k
Name: tD &A"
Mailigg Address:
City ittc
Phone: '6120
License Exp
Unit Charoe
93.75
$113.75
5160.00
$205.00
$291.25
2.00
57.50
2.00
72.50
86.25
$116.25
5131.25
75.00
69.00
75.00
50.00
50.00
93.75
80.00
5. 86.25
27.50
57.50
86.25
43.75
2
d
State: W Zip: A536
45/— A as
Sign of sr, electrical contractor or electrical administrator
X oats: 5. [6toci.
ILSE E89 09E
RECEIVED
MAY 5 2009
LIGHT DEPT
Contractq Information
Name: A ((Z P LO EkT
Mailing Address: C
City 5F-15h1V State: W
Phone:
License (Exp.
Total �Oty Multiplied by Unit Charggl
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 Circuit W/ Service Feeder
Branch Circuit WIO Service Feeder
Each Additional Branch Circuit
Temp: Service/ Feeder 200 Amp.
Temp. Service/Feeder 201.400 Amp.
Temp. Service/Feeder 401.600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Sign1Outline Lighting
Signal Circuit/ Limited Energy Commercial
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi Family Dwelling
Manufactured Horne Connection
Renewable Electrical Energy SKVA System or Less
First 1300 Square
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
ach Swimming Pool or Hot Tub
$_9,L Thermostat
Total
0
s
Owner es defined by RCW.19.26.261 (1) Owner wilt occupy the structure forfwo years after this electrical pound Is finalized (2) Owner is required to hire an
electrical contractorr if above said property is for salt rant Or lease.
After reading the above statement, I hereby certify that am the owner of the above named property or a licensed electrical contractor. I am making the electrical
installation or alteration in compliance with the electrical laws, N.E.C. RCW. Chapter 19.28, WAC. Chapter 2964468, The City of Port Angeles Municipal Code, and
Utility Specifications.
0�.d 2 f I d WtJL£ I I 6002 SO ReW
Site Address:
CITY OF PORT ANGELES
LIGHT DEPARTMENT
PERMIT NO.
.:;>~~.s
/t9~?/9z;
I . ~
.
ELECTRICAL PERMIT
DATE
Installed By:
~
il:il'1EADY FOR
INSPECTION
license Number:
o WILL CALL FOR
INSPECTION
Phone:
Owner/Business;
Phone:
Owner/Business Address;
Sq. Ft.
~ 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)
o New Construction
o Remodel
o Service update/alter/repair
!!f Add/alter circuits
o Auxiliary power
(list below)
o Special equipment
(list below)
~ Overhead
o underg)p;unr{p
Voltage ~ 2.- .
~10 0 30
Service size Amps
o Temporary
DetailslDescription:
WIRL
;;(
6,A~~\
.
W.S. No. Service
Capacity: 0 O.K. 0 Not O.K.
o Ditch inspection O.K.
1f'",,)i1 Rough.in/cover O.K.
r:r 'b O.K. to connect service
~~ Final O.K.
Size
Comments
Date
Hold for: 0 Easement 0 Letter
o Signed up for service/meter
o Meter Department notified for installation
o Fire Department notified of inspection
o Pian Review approved/pending
Installer;
Permit/Receipt No.
:2gS3
Site Address:
New Meters
.
Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work
must not be covered or electrically energized before inspection and O.K. for covering or service has been given
by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT.158 or EXT. 224.
.- - J~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT "./U'1
~ ~o~
, Insp ctor Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
OLYMPIC PRINTE;RS. INC.
t9<l' '17
FEE RECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
000,106
PERMIT NUMBEA
"
.-
/.-1:pJ- ~"Me~*J.tf/~ . ( l-foN1~
TOTAL FEE d
CONT. LIe. NO. TIME TO COMPLETE NO. STORIes LEGAL OCCUPANCY
-
1
ELECTRICAL PERMIT ONLY
14
NO OCCUPANCY OR USE ESTABllSHED UNDER THIS PERMIT
E T ADDRESS IS RESPONSIBILITY OF APPLICANT PERMITS WITH WRONG ADDRESSES ARE CANCELLED T' . ~~
Owner Installation By 1319 13 ~ E L.cc.
Owner's Address J.?t W Y-I--L Installers Address /"); ().. 7 ~~..eA' /'l1l?ir
Day Phone' Installers Phone 4- Z - .,...~ '
Application is h.erl?by l"fIade for permit to install ~Iectrical Equipment as follows: t".H~ ~ '/ ~~ ~~
_3 171'/ / dw .I de 'J/,' j"je5
Iff}
/-~
Wiring M!3thod
.
AMP 240V NUMBER AMP 120V 24QV FEE .
USE OF CIRCUIT NUMBER PER 120V 100A FEE - USE OF CIRCUIT PER 100R
CIRCUITS CIR 10 30 CIRCUITS CIR 10 30
LIGHT I SIGN
LIGHT - - 50 VOLTS -. _.
OR LESS
. .. -
CONVENIENCE MOTOR
CONVENIENCE - . \ MOTOR ,', ,
,
3 .' .,:. ~ \ MOTOR .- . ., ,'0.,,;
APPLIANCE ... - "
..
DISHWASHER _ I FIRE ALARMS .. .
DISPOSAL / BURGLAR ALARM
RANGE / MISC.
OVEN
WATER HEATER
LAUNDRY
DRYER REINSTAllATION LIGHT FIXTURE # . .
FURNACE - sue TOTAL FEE -
GAS. Oil
FURNACE ENERGY FEE
ELECTRIC BASIC FEE
ELECTRIC HEAT '1;5. 0,0
TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT ~REAKER
-
A.C. UNIT AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
-..
SERVICE AW.G.
- I SUB-TOTAL J~ <l, gf) 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 c
1915..>
cr~
r
ectrical Code.
Date Application made
Date Permit Issued
.-. 'l- r -r-S-
I WARNING I
CONTRACTOR OR OWNER AUTHORIZED AGENT)
Permlssio_n is hereby given to (jo the above described work, according to the conditions hereon and accordin to the approved plans,and
specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles. '~ ..
- DIRECTOR OF CITY LIGHT _
-BY~~~/~- \~ -,
PLANS AP veD . \ f \ . '. I' I , .
- - 1.... I
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.
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
OLYMPICPRINTERS, INC. _ __
.- .-
'. .
\ ",; f
,i' j'I';"
U\:U
REPORT OF INSPECTOR
DATE OF VISIT MADEBY REMARKS
,
., , '. .. '. , ; . , .
, , ,-
.
, .. "
, ,
. . .
.. ~ ,
.
\
.
, .
.
,
I .',
, ./ . . I , , - ..
,jJ!z;/.,n ,L -1/1 Jr: i0/r ~ f.-.V ILl J (fz.rJ
I .
,
. .
.
-
.
.
-
,. . ..
- .. ..
.
-
,
1- '1- (S- m//f '. , c' ,.,
O.K. FOR COVERING
.J, ,
, U.n.. IU....UI~'......... !lEP"'~
Iq-/~t '. ,
~b . 1/J'fJ FINAL O.K.
I'. I ' " . ,
.
-.
.
I .
, .
.
z
Cl
a:
<
::E
~
:I:
I-
Z
W
l-
.
l-
e
z
e
c
.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 16032
. .
/0 -;;r ?...->
Plirt Angeles, Washlngtonoom.._..m..oo..........oo.................oo.......mm. 19m...oo
I
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.
Address ___!,..?.b....J'~.oo.~r.t:...u.moo...oo.mmoomoommum Occupancy....oo.d:_/.~.moomoo_m___...m.
~:~=~ ~.~:~;:.~~~~~:~..~~::~~;::~~:::::::::::::::::::::::::::::::::
u /:)0/:;;;-0
Light Outlets..............................._.._..... Service, volts /........::...._........:....h........
Receptacle Outlets....m_....................... No. wIres ....___.~..................t..L..
Slz. wlr.shh_~4._r."?:::.~_..
Main fuse -:?:..-!F.9D...9...4:.....
~
Enclosure ..n...:............___......m.......
Dryer, KW __uuuu...u......._.........u...._...
Range, KW..h_....h......h....h....
Water Heater:
KW.......h.hhnnnh..........n
Type of wIring:
Entrance Cable .m..'"
Heat: K.W...................................................
Moto~~....v01t8 ~i!hase:
A.......'L~J.L......................
Rigid Conduit .h.....n.........h..........
Metal\1c Tubing .........nh....
Current transtormers:
No. & Size...._................_......
Ser. NO.................h........h..__..............
Ser. No. .................n..........................
Ser. No. .............................................
Total Load.............................
Ser. No..............................................
Remarks: oo.m.oo.........m.mmmm.oomoo..m...........__...__....un..oo..__..____.___.oomoom...m.m.oomoo...mm...oom.....mm.m.m
Total............_..........................
Type 01 Wiring:
Armored Cable ..........................:._
Non.Metalllc .................................
Knob & Tub.hn..............................
RIgid Conduit .h............................
Metal\1c Tubing ...........................
Raceway ..............................._......~
CIrcuits, Light.......................................
Utility ..............._......_.................n.
Heat ......................................._......
Range ......................_......h..............
Water Heater ...............................
Motor ..._....................._..................
Dryer u.....h......................................._
Furnace ........h..___...........R...................
__n.nn_____u__.__u..u.._._~___h____.________n_____.n..____.unn....__...nn_hn__n.__n____n__n__u.___....n_..___u.n______.________________hnnu___.n.~_
.;:~;~--;::uu--.--.--.....oo---mm.;~~~:.oo~:~~;~~...u--...----__m....mumu'--Oi~/--OOij7"'l.m.m..~.m.m.
$.~......_______________.._.n_.__..._. NO._______.....n.m.......... By ._-:-~~__..~...!___~4..h_~~:._~_!:!d:.-..::"
NOTICE-Current must not be turned on until Certificate at Inspection has been Issued. If work Is to be con-
cealed due noUce must be given the Inspector so that work may be Inspected betore concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N?
16032
Address.............._......._..................._........._..........................................._.......................................Date..._......_.._......_.........._:.._.__..._.__.........
Owner ........n....n............nnn._.........._......_......_n_.........................................h................ Tenant..h..n...............................................nn.....n..
WirlngContractor..................................._n...._.............._................................h...........................By............................................................._
NOTICE-Current must not be turned on untn CertIffcate 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 betore concealment.
......,.~_,~ t)pl~.....a T.....