HomeMy WebLinkAbout1120 E 5th St - Building
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FEE RECEIPT NUMBER
CITY OF PORT,ANGELES,.
DEPARTMENT OF LIGHT
APPLlCATION.AND ELECJRICAL PERMIT
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PERMIT NUMBER
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TOTAL FEE
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CONT. lie. NO.
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TIMETO COMPLETE
LEGAL OCCUPANCY
ELECTRICA~ PERMIT,9NLY
SiteAddress /Jd-. tJ' 54.,-1 J -/:1, S7,
CORRECT ADDRESS IS RESPONSIBILITY OF APPLICANT PERMITS WITH WRONG~DDRESSES ARE CAN~ELfE_D /_.
Ow~~r LArr-'-~Su1; ~~/Lj Installation By fl"'''~6 r")1S1rv<-Y:dl-.
Owner's Addres/ II. 0 :4 j-, J'-~ s;;L Installers Address I ~'I) sr~ cJ-~ <,oLs ;f?"I,
Day Phone 452 -/5"') L Installers Phone qJ 2-.,-/ S ' ,
Application is hereby made for Permit to ijl}tall.E~ttrical EqU~e.n~S\f91197W : r't yc... iJ /f- J) '/-1'6;'1.) j t!;t
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NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
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Wiring Method
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NUMBER AMP 240V NUMBER AMP 120V 240V
USE OF CIRCUIT PER -120V- 100A FEE USE OF CIRCUIT PER 100A FEE
CIRCUITS CIR 10 30 CIRCUITS CIR 10 30
LIGHT / SIGN ..
50 VOLTS , '.
UGHT OR LESS
CONVENIENCE. I MOTOR , ,
CONVENIENCE f MOTOR
APPLIANCE -- " , MOTOR
DISH.WASHER -- ., . FI~E 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
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A.C. UNIT AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE AW.G.
'1 SUB.TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH
I certify that the work to be performed under "th-is permit will be done by the installer and in conformance with the N,E.C. Electrical Code.
DateApplication made J h "j /8' -/ ,19 By .. ~ .,
. I' '. CaNT OR OR OWNER (OR AUTHORIZED AGENT)
, Permission is hereby given to do the above described work, accor~ing to the conditions hereon and according to the approved plans and
specifications pertaining thereto, subject to compli"ance with the Ordinances of the ;City of Port Angeles.: " ., ~ ':. ~. \ ..:~ ~ ~~
o RECT OF CITY.L1GHT ,'" ,. .,
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By
PLANS APPR
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Date Permit Issued
WARNING
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Notify Department of City Light by Street Address and Per it Number when ready for inspection. Work must not
be coyered 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
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REPORT OF INSPECTOR
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DATE OF VISIT MADE BY REMARKS
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O.K. FOR COVERING
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O.K. T.? CONNECT SERVICE
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FINAL O.K.
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . . .
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REQUEST:
Date Z. - 1<:: r 6'6
Time /:?D ~I"'-- Received by De><-"",'"", E (phone, person)
Location of Work to be inspected It 20 E - 5~
Name of person requesting inspection 1)e",,,u S E.
Address of person requesting inspection Cer,tJ Yo.. rd
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Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney Plumbing Final
Phone No. '/17 -<f,g<{-'7
Permit No.
Sewer Excav. OtheCtJ",--+ L Q ,
INSPECTION NOTES:
Inspected: Date '2- - I~ . 0 8
Re~arks:, P-e...(,c...', r <=-,J z .,
z of' S<:.-l.. go F?v'.c....
Time s: 50
C- S:. Lv r-r- h.. 2
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RESTORATION REQUiRED...... YES
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # '3 f>"3 '-/ C,- Z~'I
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
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