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Home My WebLink About1425 W 5th St - BuildingPREPARED 10/13/10 8 29 22 INSPECTION TICKET PAGE 10 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/13/10 ADDRESS 1425 W 5TH ST TENANT NBR RODERICK ELSA JOHNSON CONTRACTOR DAVE S HTG COOLING SRVC INC OWNER RODERICK H ELSA E JOHNSON PARCEL 06 30 00 0 1 2255 0000 APPL NUMBER 10 00001157 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS SUBDIV PHONE (360) 452 0939 PHONE (360) 457 4081 ME99 01 10/13/10 MECHANICAL FINAL TIME 01 00 ��4 October 13 2010 8 22 17 AM 1pangrle I v JEANNIE (DAVE S HTG) 452 0939 MECHANICAL FINAL HEAT PUMP AFTERNOON COMMENTS AND NOTES Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Application desc Ductless heat pump Owner RODERICK H ELSA E JOHNSON 1425 W 5TH ST PORT ANGELES (360) 457 4081 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Fee summary INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS WA 983631808 ELECTRICAL HEATPUMP 175273 73 50 10/12/10 4/10/11 10 00001169 932180 1425 W 5TH ST 06 30 00 0 1 2255 0000 ELECTRICAL ONLY Contractor Qty Unit Charge Per 1 00 73 5000 ECH EL BRANCH CIRCUIT WO /FEEDER Charged Paid Credited Permit Fee Total 73 50 73 50 00 Plan Check Total 00 00 00 Grand Total 73 50 73 50 00 I0 /J3/t lal i3 ho PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 Plan Check Fee Valuation DATE. RESULTS Date 10/12/10 EXTRA MILE TECH ELECT LLC 418 N RACE ST PORT ANGELES WA 98362 (360) 457 0198 $57 8565 Due 00 0 Extension 73 50 00 00 00 REPORT STATE SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR. Date: OCT -11 -201 09 49 AM E JANSSEN City of Port Angeles Permit Applteetlon Building DivIelonlEleetrleal Inspections 32i East Fifth Street P.O. Box 1190 Port Angeles Washington, 99362 Ph: (350)417.4735 Fax: (380) 417.4711 Dale. 1� 1 1 I V 1 B 2 Single Family Dwelling Multi- Faintly or Commercial' Commercial Addition I Alteration Remodel Per rir Pion Review May Ete Required. Please C:omprele EUlryncel Pion Review Information Sheet Job Adare68. f `ri .rt a r t1uilding Square Footage. Description of above Owner Information 1 Cgnlractor Information Name: �er (5 s� Name gX /Ltd 10, 7 C/ `(.-r IICt`ac'L Mailing Address. '7 c r Mailing Address: 'I 1 E3 r..[ .1.'_.l! E City' i 4t Stale: ?ii: 7 City __PA State: c.rp .tl c?_ Pnone:_t5 7'6�si Fax. Phone. YS7- .12._ Fax: License Exp.._ License Exp 1„__ 7'_./.l -1,2 6 x 11 1,1nil Charge 119.90 S 145.5Q S 204.60 26210 5 372.50 4 2.60 S 73.50 S i.60 5 82.70 S 110.30 148.70 167.90 S 95.90 S 96.20 S 95.90 3 63 90 3 63.90 5 119.90 S 107.30 .5 110 30 3 35.20 3 7350 5 110.30 rib 00 G h si1 r clt De tru gt isle) IOIv Multiplied by Unit Charo*l SetvlcaiFeeder 200 Amp Service /Feeder 201 -400 Amp o Service/Feeder 401.600 Amp 3 Service/Feeder 601 -1000 Amp 5 Service(Feeder over 1000 Amp Branch Circuit WI Service Feeder j, branch Circuit W/O Service Feeder i Each Additional Branch Circuit Temp. Service! Feeder 200 Amp, Temp liervice!Feeder 201 -400 Amp Tamp Service /Feeder 40t -600 Amp Temp Service/Feeder 601.1000 Amp Forint to Portal Hourly Si9NOulline Lighting Signal Circuit( Limited Energy -Commercial Additional 1 10 Sb 01.1 S Signal Circuit/ Limited Energy 1 8 2 Family Dwelling 3 Signal Circuit/ Limited Energy Multi Family Dwelling Manufactured Home Connection Renewable Fleclrical Energy SKVA System or Less Firal 1300 Square ft. Each Additional 500 Square Fl. or Portion of S F -tech Outbuilding or Detached Garage Each Swimming Pool or Hot Tub Thermostat _2 t. S.. total 7 r. II (r CU i 1 2009 ELECTRICAL INSPECTIONS 0 Credit Card If 360 452 2982 Signature of owner electrical contractor or electrical administrator 1.,1 Cash P 01 Owner as defined by RCW.19,28,1e1 0) Owner will occupy the struchrrrt for two years after this electrical permit is finalized. i,'i Owner is required to hire an electrical contractor If above said property is ler sale, rent or lease. Perntll expires alter six months of last Inspection. Alter 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 of alteration In compliance with the electrical laws, N.E.0 RCW Chapter 19.28, WAC, Chapter 296468. The City of Pod Angela Municipal Code, and Utility Specification, CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc INSTALL A DUCTLESS HEAT PUMP Owner RODERICK H ELSA E JOHNSON 1425 W 5TH ST PORT ANGELES (360) 457 4081 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge 1 00 Fee summary Permit Fee Total Plan Check Total Grand Total 14 8000 EA T:FormsBuilding Division/Building Permit WA 983631808 Per Charged Paid 64 80 00 64 80 10 00001157 735668 1425 W 5TH ST 06 30 00 0 1 2255 0000 RODERICK ELSA JOHNSON MECHANICAL APPL PERMIT RS7 RESDNTL SINGLE FAMILY 4020 BASE FEE ME FURN /HP /FAU Contractor DAVE S HTG COOLING SRVC INC PO BOX 413 PORT ANGELES WA 98362 (360) 452 0939 MECHANICAL PERMIT DUCTLESS HEAT PUMP 175117 64 80 Plan Check Fee 00 10/08/10 Valuation 0 4/06/11 64 80 00 64 80 OR 5 TON Credited Due 00 00 00 Date 10/08/10 Extension 50 00 14 80 00 00 00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) c 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 c ruction (Apo D>aiv vi C Dl L Date Print Name ignature of Contractor or Authorized Agent V Signature of Owner (if owner is builder) 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 Furnace 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 I ESA. Landscaping I SHORELINE. Inspection Type Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 T Forms /Building Division /Building Permit FINAL Date Accepted by IFINAL Date IU-13" FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE 10 Accepted by Sw Date Accepted By Oct 0710 08 55a 1) a \j-& 5 k tat --t-i k "s Property Owner's Address (f S CA.) e mot S S'Fr"e.e.: Contractor Dew-e-is Phone Contractor's Address P o &:g c `1 -Port s 4 Ii" License 1 kc Expiies E -mail PROJECT ADDRESS Lot Zoning Residential o Multi- family o Commercial o Industrial Applicant Property Owner Parcel Number Dave s Heating Cooling Project Time Brief Description: Check all that apply o New Construction o Addition o Remodel o Repair o Demolition o Re -roof 6Heat System o Other 3604520939 p 2 BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn. Building Permit Technician 321 E. Fifth Si Port Angeles, WA 98362 (360) 417 -4815 fax (360) 417 -4711 Max. height of proposed structures ft. Occupancy group Will a lawn sprinkler system be installed? Occupant load Will a fire sprinkler system be installed? Construction type For City Use Only Date Received_ -7-10 Permit 1 b 115 7 Date Approved Phone `f5 a_oq Phone X57- 4 40?I o House o garage o other o tear off re -roof o lay over one layer J-leat pump o wood burning stove o gas fireplace o pellet stove o other Floor Areas Existing (scr. ft.) Proposed (sa. ft.) Basement per sq. ft. 1 Floor 2" Floor 3 Floor Garage Carport Covered Porch Deck Shed Other TOTAL VALUATION Total footprint of structures sq. ft. Lot size sq. ft. Lot coverage Site 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 It of bedrooms *of full baths of half baths have read and completed this application and know it to.be live and correct. I am authorized to apply for this permit and understand that it is my,responsibility to determine what permits are required, and to obtain permits priorto working on projects. f j 1 Date 1 i P Print Name -J (6Y'P#i karrii' Signature T:Forms/Building Division/Bldg Permit.doc Clallam County Assessor Treasurer Property Details 56775 RODERICK H AND E Page 1 of 5 Clallam County Assessor Treasurer Property Search Results 56775 RODERICK H AND ELSA E JOHNSON for Year 2010 2011 Property Account Property ID 56775 Legal Description LOT 14 BL 122 Geographic ID: 0630000122550000 Agent Code Type Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11 Open Space. N DFL N Historic Property* N Remodel Property* N Multi Family Redevelopment: N Township Section. Range Location Address: 1425 W FIFTH ST Mapsco PORT ANGELES WA Neighborhood. Cycle 5 Res Map ID* 3 Neighborhood CD: 10955130 Owner Name RODERICK H AND ELSA E JOHNSON Owner ID 33275 Mailing Address: 1425 W 5TH ST Ownership 100 0000000000% PORT ANGELES WA 98363 -1808 Taxes and Assessment Details Property Tax Information as of 10/07/2010 Amount Due if Paid on. E. Exemptions. NOTE If you plan to submit payment on a future date make sure you enter the click RECALCULATE to obtain the correct total amount due. First Second Half Half Base Base Year Statement ID Taxing Jurisdiction Amt. Amt. Penalty Interest Base Paid 2010 39806 ST SCH STATE SCHOOL $206 04 $206 05 $0 00 $0 00 $206 04 2010 39806 CC -GEN COUNTY $109 65 $109 65 $0 00 $0 00 $109 65 2010 39806 PORT PORT $15 41 $15 41 $0 00 $0 00 $15 41 2010 39806 PORT ANG PORT ANGELES $253 86 $253 89 $0 00 $0 00 $253 86 2010 39806 SD #121 SCHOOL DISTRICT #121 $266 88 $266 89 $0 00 $0 00 $266 88 2010 39806 NTH OLY LIB NORTH OLYMPIC LIBRARY $31 86 $31 86 $0 00 $0 00 $31 86 2010 39806 HOSP #2 HOSPITAL #2 $44 98 $44 98 $0 00 $0 00 $44 98 2010 39806 WSMET PK DIST WILLIAM SHORE MET PARK DIST $14 32 $14 31 $0 00 $0 00 $14 32 2010 39806 CITY_STORMWATER CITY STORMWATER $36 00 $36 00 $0 00 $0 00 $36 00 2010 39806 WEED_CONTROL WEED CONTROL $0 82 $0 81 $0 00 $0 00 $0 82 2010 39806 TOTAL. $979.82 $979.85 $0.00 $0.00 $979.82 2009 567752008 ST SCH STATE SCHOOL $235 94 $235 94 $0 00 $0 00 $471 88 2009 567752008 CC -GEN COUNTY $119 40 $119 41 $0 00 $0 00 $238.81 2009 567752008 PORT PORT $16 91 $16 92 $0 00 $0 00 $33 83 2009 567752008 PORT ANG PORT ANGELES $261 91 $261 90 $0 00 $0 00 $523 81 2009 567752008 SD #121 SCHOOL DISTRICT #121 $291 78 $291 78 $0 00 $0 00 $583 56 2009 567752008 NTH OLY LIB NORTH OLYMPIC LIBRARY $34 70 $34 69 $0 00 $0 00 $69 39 http. /vpn. clallam.net: 8084 /propertyaccess /Property. aspx ?cid =0 &year= 2010 &prop_id =5 6 10/7/2010 .. CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 PERMIT NO 3 &PD 1/-/y-'i'C- DATE ELECTRICAL PERMIT Site Add ress: /L/,;lS- tV. Sf4 o READY FOR o WILL CALL FOR INSPECTION INSPECTION Installed By: 7<./Jcf .JohlllStPlU I License Number: Phone: Owner/Business: Phone: OwnerfBusiness Address: Sq. Ft. ~SIDENTIAL o COMMERCIAL . ~ BASEBOARD KW _ o FURNACE KW _ o FAN/WALL KW _ o HEAT PUMP KW o SIGN o TEMPORARY SERVICE o PERMANENT SERVICE o NEW CONSTRUCTION l?! REMODEL o ADD/ALTER CIRCUITS ,% SERVICE UPGRADE/REPAIR o SPECIAL EQUIPMENT (LIST BELOW) ~HEAD SERVICE o UNDERG80UN"B ~I'WICE VOLTAGE: l:;2c9/..;2. V o SINGLE PHASE o THREE PHASE SERVICE SIZE ~D AMPS Details/Description: J110 vf C JC / f h A/ '7 :5 Uvr'c.L ( K t.vu /IC 2'- CK/s ,8I?:$Cb&;hec/ -- ( /L/' /PCts.~ , . cE x/Ch\N ( If" fl1J4-rV S. W.S. No. SERVICE SIZE CAPACITY: o O.K. NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o CHANGE SERVICE WIRE o OTHER A I\'t;D Ditch Inspection O.K. ./ IJ' ~ Rough-in/cover OK ~tJ. OK to connect service o Final O.K. ~ Permit/Receipt No. ~~otJ Installer: New Meters Date: ,/-/y-f'C . Notify Port Angeles City Light by Street Address and Permit Numberwhen 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. # f NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ~ ~[1 ~ ~ $ l./ E . , lectncallnspector Permit Fee WHITE - File by address YEllOW - file by number PINK - Top: Eng, Bottom, Customer GREEN - Top: Meter Dept., Bottom: City Hall OLYMPIC PRINTERS INC. /~77 FEE RECEIPT NUMBER , CITY OF P,QRT ANGELES DEPARTMENT' OF" LIGHT .APPLlCATION AND. ELECTRICAL PERM A /09)-- PE:RMIT NUMBER ., 0: JI) , ~ , ., . TOTAL FEE /(:,~O() / CONT. Lie. NO. TIME TO COMPLETE NO. STORIES LEGAL OCCUPANCY ". -. . ~ /# _ .EL_E1TA'(;AL~Z60Nl~ Site Address /7i:?"5 bU. 6 . ' CORRECT ADDRESS IS RESPONSIBILITY OF APPLICANT Owner ~)~-bbJ'e, . /?/;/#..{?... .. , . Owner'sAddress '/'9.:2/'::,,- 'vI, s,/J::> ., . 0/0_-//75 . . . NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT PERMITS ~ITH WRONG ,ADDRES~~A~K~; . ~ fJ. Installation By :We ~ . C. Installers Address P tf? L:>bx; ./~7./ instaliersPhone. '0-7'-:;7/20 . ' . _'~:,..L<7..1P ..6R'/.?/e/Z- j- PYJ'&- lv:Vi~ing Method Day Phone Application is hereby made for Permit to install Electrical Equipment as follows: '14/?~ .hedRP&7/J! .' . . . . , NUMBER AMP .12DV 240V NUMBER AMP 120V 240V USE OF CIACUIT PEA - 100R "FEE USE OF CIRCUIT PER 100A FEE CIRCUITS CIR 10 30 CIRCUITS CIR 10 30 LIGHT SIGN u. 50 VOLTS .. .. LIGHT OR LESS CONVENIENCE I .. 'v" .. MOTOR .. Z...!' CONVENIENCE .. MOTOR , APPLIANCE .... MOTOR _ DIS~VfASHE!:l .... .. .. FIRE 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 ELECTR1C.HEAT_ /. .Z.O - V .. 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. , . - --.- . r SUB~TOT AL .. SIZE OF GROUND SIZE OF ENTRANCE SWITCH ~~te APPIi~ation mad; ~JZ/ j /(<7 .. ~ - - .> . - ~- .. ./. ,19 f!l7 By lcal Code. I certify. ttiat the work to be performed under this permit will be done by the installer and in'.conf .' ~i;;ued I WARNING CONTRACTOR,OR OWNER (OR AUTHORIZED AGENT) Permission is hereby given 10 do the above.described work, according to the conditions hereon and a6c.ording to the. approved plans and. specifications pertaining thereto:.s~bject to compliance with the Ordinances of the.City of Port Ang~les~.. ':.. ,.', " I.. .. ': '., 'DIRECTOR O~liY LIGHT.. ".' ,"" \ ~;A:~~:;Z . ~ dp ; - . . ... Notify Qepartmenl 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 REPORT OF INSPECTOR DATE OF VISIT MADE BY REMARKS . .. . . .'(" . < " .' < : . . . . 'on .. . . . \ --:- . , -- - .. ..... .. , J J. '" 4/?V!?1 $// (Iii O.K. FOR COVERING < 'T -., , 11--'" . . .() It T!.__....__._ ... _.!~!tAL.O.K. '. , . ; , , ./ z CJ a: << :E ~ J: I- Z W I- ~.' ~ - I- o Z o C . ), l' CITY OF lPORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT Nt! 17230 ,#' Port Angeles. washlngtonh.......rh.:.~__2:=_m__m_mmm___m.___.. 19/;{.9 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 h)i!.2:__~..h4!=1')_.2._tt:.._.___....___m....mmm.___ Occupancy..,L!_/.~12_m'm_m.....m...____... ~:::~~;:~~~;:._--~~::~~;~:::::::::::'.-.-:.-.~::::::::::~::::::::::::::::~::::::::::~::::::::: Light OutletB..._.........................._.._..... Service, volts .1..?..:9L.;f.:8'~ Type of Wiring: '.,3' . No. wires __......__..__........p..____... Size wlres....,(?:'.tt...6................... Main tUBe .....~~Q.A'!........... Enclosure ....,s.............__..__m....... Receptacle Outlets............................... Dryer, KW._nnn..........................__.___.. Range, KW m__......_mn__.__u Water Heater: KW.....................r................ Heat Kw.....L2-..:?.,......ll..B........... Type of wiring: Entrance Cable ......__n____.___..... Motors: size. volts and phase: Rigid Conduit ..__'___m_mom__ Metallic Tubing ................. Current transformers: No. & Size....................................... Ser. No............____......__.............__....... Ser. No.............................................. \ Ser. No....__................__.........__.__........ Armored Cable ................__............ Non-Metallic ................................. Knob & Tube.................................. Rigid Conduit ..........................._.. MetaUlc Tubing ........................... Raceway ......................._.....____ Circuits, Light.........................__............ Utlllty..............._............................ Heat ......................................._.._ Range ............................................. Water Heater ............................... Motor ............................................. Dryer...............................__.......__......_ Furnace ...................................__......__. Remark:~ta:..=~:;::.;.~~:..:_~.,__~..:::~.~::.~:.~~~1mm___________...~:~::..::::~:_:_::~::._:::.~.:.~_::~::~_ ............................................................................--.-----..--...........................-...-.--...--..-.--...--........-...-...........---....-... _;~:.~~.-~~~~~_~__~___~_:~.~__~---.m--::~~_~:__:~_~_~~~_~-.....___-----.---m---m~;--.~Z~2~;.:~::Z~ NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work Is to be con- cealed due notice 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? 17230 Address............................................................................................................n..........................Date..........._.._.._.._.........._.............._......._ Owner..................................._.........._.................._...........................................................Tenant......................._........................................... \ WirIng Contractor .......................................................................................................................... By............................................................... NOTICE-Current must not be turned on untU Certlt1cate of Inspection has been Issued. It work Is to be COD- . cealed due notice must be given the Inspe~~or so that work may be inspected before concealment. .' 1M Olympic Printers, Inc.