HomeMy WebLinkAbout926 W 4th St - Building 'ELECTRICAL PERMIT f t 1
CITY OF PORT ANGELES
360 -417 -4735
Application Number 11- 00001043 Date 9/22/11
Application pin number 585404 REPORT SALES TAX
Property Address 926 W 4TH ST our excise tax form
ASSESSOR PARCEL NUMBER: 06-30-00-0-1-0615-0000- on y
Application type description ELECTRICAL ONLY to the City of Port Angeles
Subdivision Name
Property Use (Location Code 0502)
Property Zoning
Application valuation 0
Application desc
3 ton heat pump
Owner Contractor
RICHARD J HOPKINS ALL WEATHER HTG COOLING INC
926 W 4TH ST 302 KEMP ST
PORT ANGELES WA 983632108 PORT ANGELES WA 98362
(360) 457 -4523 (360) 452 -9813 t i6 z 51....7-3
Permit ELECTRICAL ALTER RESIDENTIAL 7
Additional desc
Permit pin number 193037
Permit Fee 56.00 Plan Check Fee .00
Issue Date 9/22/11 Valuation 0
Expiration Date 3/20/12
Qty Unit Charge Per Extension
1.00 56.0000 ECH EL- LVT- THERMOSTAT 56.00
E;
Fee summary Charged Paid Credited Due
Permit Fee Total 56.00 56.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 56.00 56.00 .00 .00
V
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH -IN
FINAL
COMMENTS: I" l? ASV 3/-711-Z 1�1�
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G: \EXCHANGE \BUILDING
1.0131 4N, ELECTRICAL INSPECTION
U A�N
WIRING REPORT
o 417 -4735
D ERON J RA)OR PERMIT I t- 104 INSPECTOR
w 5 r 2 -4/ t, i`a=T� -t L
ADDRESS
21 C> AA)
APPROVED NOT APPROVED
DITCH
ROUGH IN /COVER
SERVICE
FINAL
CORRECTIONS NEEDED: U Pb i 1ZG 17 1 KE
171 CV O IJ (Tr w1 Wit.
C -LS5Z s (s
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
DO NOT REMOVE
OLYMPIC PRINTERS, INC. (360) 452 -1381
09/21/2011 09:54 13604525177 ALL WEATHER HEATING PAGE 05/05
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CITY OF PORT ANGELES PERMIT APPLICATION SE 2 1 2011 d
Building Division/Electrical Inspections ECTRtCAL I L
321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 9836
Ph: (360) 417-4735 Fax: (360) 417 -4711
I NNW
171 C112.111t
'(1 2 Single Family Dwelling Multi Family or..Commercial* Commercial Addition Alteration Remodel Repair"
x Plan Rev ay B- R -qui Ple- e Com.lete Electrical Plan Review Information Sheet
Job Address: r. r 0 ya aN•
Building Square Footage:
,rtIon .f:b•ve l. J„1
1. 11 i 41114111F01111!"1 Tr1i a �le71l�l Rtf'ifIIIItiR►TWi 11.11ili/t0i AAA
Owne fo atio Cont for Information
Name: :4 ,1 1 1 1 11 11. Name: s
Meilin. Address: r numni. INS Mailing' ess: yam' i 7 ii
Cit State: Zip: 'raw. C d State: Tii ZI.: "741111'
�,1 i
Phone: ;x:
Phone. v. ►A Fax: is^
License Exp. License Exp.: n'1fftil
451 -t -1.3
Item Unit Charge 2,}tt Total (Qty Multiplied by Unit Charcte)
Service /Feeder 200 Amp. 119.90
Service /Feeder 201 -400 Amp. 145.50
Service /Feeder 401.600 Amp 3 204.60
Service/Feeder 601 -1000 Amp. 262.20
Service/Feeder over 1000 Amp. 37250
Branch Circuit W/ Service Feeder 2.60
Branch Circuit W/0 Service Feeder 73,50
Each Additional Branch Circuit 2.60
Temp. Service/ Feeder 200 Amp. 92.70
Temp. Service /Feeder 201-400 Amp. 110.30
Temp. Service/Feeder 401.600 Amp. 148.70
Temp. Service /Feeder 601-1000 Amp 167.90
Portal to Portal Hourly 95.90
Sign /Outline Lighting 88.20
Signal Circuit/ Limited Energy First 1500 sf Commercial 95.90
Note: $5,00 for each additional 1500 sf
Signal Circuit/ Limited Energy -1 2 Family Dwelling 63.90
Signal Circuit/ Limited Energy Multi Family Dwelling 63.90
Manufactured Home Connection 119,90
Renewable Electrical Energy 5KVA System or Less $102.30
Thermostat 56.00 i QD
NEW CONSTRQCTI0N ONLY
First 1300 Square Ft. 110.30
Each Additional 500 Square Ft. or Portion of 35.20
Each Outbuilding or Detached Garage 73.50
Each Swimming Pool or Hot Tub 110.30
LakalTotal
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years atter 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, I hereby certify that I 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 296 -460, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications,
Signature of owner, electrical contractor or electrical administrator: 0 Cash Chock
at l 1J Dated: q /I I t 1 Credit Card
01/012010
CITY OF PORT ANGELES
ECONOMIC DEVELOPMENT BUILDING DIVISION
DEPARTMENT OF COMMUNIT
¶L. Pte V
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 11- 00001040 Date 9/26/11
Application pin number 902880
Property Address 926 W 4TH ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-1- 0615 -0000-
Tenant nbr, name RICHARD J HOPKINS on your state excise tax form
Application type description MECHANICAL APPL. PERMIT
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
Property Zoning
Application valuation 4035
Application desc
HEAT PUMP
Owner Contractor
RICHARD J HOPKINS ALL WEATHER HTG COOLING INC
926 W 4TH ST 302 KEMP ST
PORT ANGELES WA 983632108 PORT ANGELES WA 98362
(360) 457 -4523 (360) 452 -9813
Permit MECHANICAL PERMIT
Additional desc HEAT PUMP
Permit pin number 193011
Permit Fee 64.80 Plan Check Fee .00
Issue Date 9/26/11 Valuation 0
Expiration Date 3/24/12
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
Finale to(Lti
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.
gjdCol !I \e' i d iOn At
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
5-
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 FINAL Date Accepted by
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 FINAL Date Accepted by
MANUFACTURED HOMES: CV /1
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical 417 -4735
Construction R.W. PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750 C
Building 417 -4815 t t J u1
T:Forms /Building Division /Building Permit
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09/21/2011 09:54 13604525177 ALL WEATHER HEATING PAGE 02/05
BUILDING PLUMBING MECHANICAL PERMIT APPLICATION SHORT FORM
(To be used for projects that do not require plan review.) p
Date Received t -1
Permit fl [ow
City of Port Angeles Please print in ink. Date Approved
Attn: Building Permit Technician Approved by
321 E. 5th st., Port Angeles, WA 98362
360- 417 -4815 fax: 360- 417 -4711 Credit card payments are accepted Mon -Fri 8 -5 pm (no American Express)
Hours: Mon through Fri 8— 5 pm Cash checks are accepted Mon -Thurs 8:30 -4 pm Fri 8:30 :30 pm
AbLr, as/13
P PI t e♦ IS✓W► Ltm- xis Phone:ADO. L
Prope,ty� n `i i ing a drz3att 1,6A- 6 16..62,
Contractor's business namo :A11 Weather Heating Cooling Phone: (360) 452 -9813
for property owner's name If he /she Is doing /overseeing the work)
Contractor's mailing address:
302 Kemp Street
Contractor's L &I license number: ALLWEHC150KU Expiration date:
9/oti/12
Project Address: q 2Lp t s
Project Typ Residential i Commercial o Industrial o Multi- family
Project Business Name:
(for commercial, Industrial, or multi- family projects)
The following permits are usually Issued over -the- counter Immediately, without the need for plan review,
Complete only the portions of this permit that are relevant to your project.
Re -roof: c house o garage other
tear off re -roof lay over one layer
.Llcensod contractor; Submit a copy of your re roof bid.
Project Valuation (labor materials, not including sales tax)
Re side: ro house o garage other
Project Valuation (labor materials, not including sales tax)
Repair: ,explain the prolect),
IIIEN Ma11 WO 1/ I n Ci'1li+5I ial
UTi S. 0.
Project Valuation
*Homeowner: If you will be doing/ overseeing the work, then the project valuation will be determined by doubling the
cost of materials, to reflect the value the repair adds to your property.
Cost of materials x 2 Project Valuation
T:Forms /Building DlvIsion /Bullding /Plumbing /Mechanical Permit Application Short Form (Revised 2011)
Page 1 of 2
09/21/2011 09:54 13604525177 ALL WEATHER HEATING PAGE 03/05
Swimming Pool or Spa_ 24" deep): La,prefabrlceted swimming pool or spa projects that
do not require plan reviews
Obtain the City of PA handout entitled "Pools Spas" follow the requirements.
Project Valuation
Demolition: A demolition permit Is needed when an entire building gets demolished.
What will be demolished? ro house b garage GI other
Note: some demolition permit applications need to be reviewed by various City departments, and may take
approximately two weeks to obtain.
Agree to ensure that all utilities are /will be properly turned off (and capped off If needed)
prior to demolition.
Obtain (from the City of PA) an aerial view map of the parcel and put an "x" over the structure(s) to
be demolished. Submit the map with this application.
Obtain (from the City of PA) a copy of the Olympic Region Clean Air Agency ORCAA)
Demolition Permit Application.
Contact ORCAA at 360- 417 -1466 to discuss whether or not an ORCAA Demolition Permit will also
be needed.
yes no Will the debris be going to the Regional Transfer Station in Port Angeles?
yes a No If yes, will a licensed contractor be taking It there?
If yes, obtain (from the.City of PA) a copy of the Waste Disposal Application.
Complete and submit the waste disposal application to the Building Permit Technician, now
(or later If asbestos testing Is needed).
PlumbincLPermIt: jexptain the projectl
Project Valuation
Mechanical Permit: (explain the prolect)
Installation of Heat Pump
Project Valuation 1412475. t:
I have read and completed this application and know it to be true and correct. I ant 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
working n projects,
Date I I I Signature ik
Print Name V'r"u2 14zzal'.,c Jim Smf
Page 2 of 2
Clallam County Assessor Treasurer Property Details 56537 RICHARD J HOPKINS... Page 1 of 3
CieIlam County Assessor Treasurer
Property Search Results 56537 RICHARD J HOPKINS for Year 2011 2012
Property
Account
Property ID: 56537 Legal Description: W2 LT 6 E35' LOT 7
BL 106 SURVEY V19
P38
Geographic ID: 0630000106150000 Agent Code:
Type: Real
Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11
Open Space: N DFL N
Historic Property: N Remodel Property: N
Multi Family Redevelopment: N
Township: Section:
Range:
Location
Address: 926 W FOURTH ST Mapsco:
PORT ANGELES, WA Neighborhood: PA West Res Map ID: 3 1
Neighborhood CD: 5151000
Owner
Name: RICHARD J HOPKINS Owner ID: 31204
Mailing Address: 926 W 4TH ST Ownership: 100.0000000000%
PORT ANGELES, WA 98363 -2108
Exemptions:
Taxes and Assessment Details
Property Tax Information as of 09/21/2011
Amount Due if Paid on: 21 NOTE: If you plan to submit payment on a future date, make sure you enter the date and
click RECALCULATE to obtain the correct total amount due.
Click on "Statement Details" to expand or collapse a tax statement.
First Half Second Half
Year Statement ID Base Amt. Base Amt. Penalty i Interest Base Paid Amount Due
Statement Details
2011 151276 $1660.03 $1659.94 $0.00 $0.00 $1660.03 $1659.94
Statement Details
2010 39576 $1588.94 $1588.97 $0.00 $0.00 $3177.91 $0.00
Values
Improvement Homesite Value: N/A
Improvement Non- Homesite Value: N/A
Land Homesite Value: N/A
Land Non Homesite Value: N/A Ag Timber Use Value
Curr Use (HS): N/A N/A
Curr Use (NHS): N/A N/A
Market Value: N/A
Productivity Loss: N/A
Subtotal: N/A
Senior Appraised Value: N/A
Non- Senior Appraised Value: N/A
Total Appraised Value: N/A
Senior Exemption Loss: N/A
Exemption Loss: N/A
Taxable Value: N/A
Taxing Jurisdiction
Owner: RICHARD J HOPKINS
Ownership: 100.0000000000%
Total Value: N/A
Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP
Levy Code Description Levy Rate Appraised Value Taxable Value Estimated Tax
STATE SCH STATE SCHOOL N/A N/A N/A N/A
CC GENERAL CLALLAM COUNTY N/A N/A N/A N/A
GENERAL
http: /websrv8.c1a11am. net propertyaccess /Property.aspx ?cid =0 &year= 2011 &prop_id =56537 9/21/2011
Application Number 09 00000779
Application pin number 673217
Property Address 926 W 4TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 1 0615 0000
Application type description RE ROOF
Subdivision Name
Property Use
Property Zoning
Application valuation 8790
Application desc
TEAR OFF /INSTALL COMP
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES WA 98362
Owner Contractor
HOPKINS RICHARD J
926 W 4TH ST
PORT ANGELES
s orctikTocs
T:FormsBuilding Division/Building Permit
WA 983632108
Date 8/05/09
DIAMOND ROOFING ENTERP INC
P 0 BOX 2963
PORT ANGELES WA 98362
(360) 452 9518
Permit BUILDING PERMIT NO PR FEE
Additional desc. TEAR OFF INSTALL COMP
Permit pin number 151167
Permit Fee 193 75 Plan Check Fee 00
Issue Date 8/05/09 Valuation 8790
Expiration Date 2/01/10
Qty Unit Charge Per Extension
BASE FEE 95 75
7 00 14 0000 THOU BL -2001 25K (14 PER K) 98 00
Other Fees STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 193 75 193 75 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 198 25 198 25 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.
.,SZ9r,t)
t
g- /3
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
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
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 FINAL Date Accepted by
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 I FINAL Date Accepted by
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting I
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting 1 ESA.
Landscaping 1 SHORELINE.
T:Forms /Building 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
Date
Accepted By
Comments
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 I h�
Date Accepted By
0
3 -Id
PROJECT ADDRESS
Parcel Number
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
c /oor Areas Existing (sq. ft.) Proposed (sq. ft-)
Basement per sq ft.
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
ateg Print "Name :1 c t.a \A b Signatur
-orms /Building Division /Bldg Permit.doc
For City Use Only
Date Received 2, q
Permit# r-27q
Date Approve
Applicant Phone
Property Owner
Property Owner's Address ciac,
Contractor 1:■0,.d Phone Fe
Contractor's Address iO %cra9 6
License AMORE g'-4 '1ZExpire4O /1i.1 I ►t)E -mail 414
Phone t-(,cr? a�
Lot Zoning
Proiect Tvne Brief Description. }Residential Multi- family Commercial Industrial
Check all that apply
o New Construction
Addition
Remodel
o Repair
Demolition
)1( Re -roof House garage other Nartear off re -roof lay over one layer
o Heat System Heat pump o wood burning stove gas fireplace pellet stove other
o Other
TOTAL. VALUATION 4 3 I rjq('
otal footprint of structures sq ft. Lot size sq ft. Lot coverage
ite 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
lax. height of proposed structures ft. Occupancy group of bedrooms
/ill a lawn sprinkler system be installed? Occupant load of full baths
/ill a fire sprinkler system be installed? Construction type of half baths
lave read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand
at it is my responsibility to determine what permits are required, and to obtain permits prior to working on projects.
f�l
I CUSTOMER'S ORDER NO. DEPARTMENT DATE
NAME
ADDRESS
9a 6 w 4 +h
CITY STATE, ZIP
SOLD-8Y CASH` r C.O.D. 'CHARGE ON•ACCT MDSE'RETD PAID PUT
2
3
4
5
6
8
9
10
11
112
13
14
15
16
17
18
19
201
5805
C. t idc� C '1 YN. 1
1 CAa►,�\ ,ate LL.v -Lct vww.rc1
it V
j' R X G
A Ir.c_V ,-a cek
171704
it, adanw KEEP THIS SLIP FOR REFERENCE
.
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
ELECTRICAL PERMIT
PERMIT NO. s-ss,:?
C, ~o /Yt
DATE
Site Address:
7 ~r:, /{/, </It
~,
'R(G{~J f-k\LP.IJL~{~
o READY FOR
INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
Installed By:
Owner/Business:
Phone:
Owner/Business Address:
Sq. Ft.
ELECTRIC HEAT
o BASEBOARD KW _
tf FURNACE KW ~
121. HEAT PUMP KW ~
o FAN/WALL KW _
12'1 RESIDENTIAL
o COMMERCIAL
~ NEW CONSTRUCTION
o REMODEL
o ADD/ALTER CIRCUITS
o SERVICE UPGRADE/REPAIR
o TEMPORARY SERVICE
J:'1: RISER
o OVERHEAD SERVICE
ill UNDERGRhND SERVICE
VOLTAGE!ZO Z(O
JZi 1l1\ 0 3 ~
SERVICE SIZE a90
FEEDER SIZE
AMPS
AMPS
Details/Description:
fJ ew-' ~
.
W.S. No. SERVICE SIZE
CAPACITY:
o O.K. 0 NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
o INSTALL SERVICE POLE
DATE
ENGR.
o OVERHEAD SERVICE APPROVED
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection O.K.
~ Rough-in/cover O.K.
g O.K. to connect service
o Final O.K.
Site Address:
c;,;:UJ
Cu.
if
SU<A-~
New Meters
i
.
Installer: <'/~ ~
(,4-t.r.A.t.,U .
Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered
before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report
or on the Building Permit. PHONE 457-0411, EXT. 224. g.
~ NO OCCUPANCY aA USE ESTABLISHED UNDEA THiS PEAMiT $ IT' SO
, \
Electrical Inspector
Permit Fee
WHITE - File by address
PINK - Top: Eng, Bottom, Customer
GREEN - Top: Mete' Dept., Bottom: City Hal~
OLYMPICPAINTERSINC