HomeMy WebLinkAbout309 E 6th St - Building North Peninsula Electric 928-9409 P.1
RECEIVED
DEC -4. 2013
Crry OF PORT'ANGELES Pamir ApnjcAmN
Building Di-AsionMedrical Inspections ELECTRICAL
321 East FMh Street—P.O.Box 1,150/Port Angeles Washington,9ftWCTIONS
Ph:(360)417-4735 Fax: (360)417-4711
18.2 Single Family Dwelling
Plan Re ew May Be Requ Co le2lectical Plan Review lnfbnation Sheet
Job Address:
sullftg Square Footage:
Description DF abcvs,
Civmerlinformati Contra Infortnabo
Name C) t S Q Name:
IulaiingAd 2_�'_
Y-- Mallng'Add
City State' p � 2, City. Stale:
Rorie: Phone: Fmc
UGWS94 i Exp.
License IFxp. G ry, -k—
Item Mnit Charge
Total LQty Multiplied W Unit Charge)
8erv1mFeeder200Amp_ $120-00
ServJcWeader 201-400 Amp. $146.00
Servtca.Feeder 401-Fa Pop $205.00
SeMcellFeeder M 4 000 Amp. $26200
SaVin-Feeder over IWO Amp. S 373.OD
Branch Circuit W/Service Feeder S 5,00
Bran,ii Circuit W/O Service Feeder S 63-00
Each Additional Branch Circuit S 5.00
Branch Circuits 1-4 $ 75.00 $
Temp.ServiceJ Feeder200 Amp, 5 93-00
Temp.SeNceiFeeder 201400 Amp. $110.0D
Temp.ServIcOlFeeder 401-600 Amp_ $149.00
Temp.SeMce/Feeder60141100 Amp, $168.00
Portal to Portal Hourly $ 96.00
Signal CtrcuW Uated Energy-1&2 Family Dwelling S 64.00 $
Manufactured Home Connection S 120.00 $_
Renewable 8acWcal Energy-SWA System or Less $10ZDD $
Thermostat S 56.00
Note:$UO for each additional T•Siat
NEW CONMUCTION ONLY:
First 1300 Square M. S 120,130
Each AddilJonal 5130 Square FL or Portion of $ 40.00
Each Outbuilding or Detached Garage $ 74,00
Each SOmming Pad or Hol Tub $110.00
Owner as defined by RCK19,28,261:(1)Owner will occupy the struclize for two years after this ele,C*Ed permit is finalized.(2)Ovmer is required
to Wire an ialectftW contractor if above said property is far sale,rent or lease.Permit expires after six M03ft 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 mWnq
the electrical installation or alteration in compliance with the dec0cal laws,N-E-C.,RCW.Chapter 19.28,WAC.Chapter 2964613,The City of Port
Angeles Municipal Code,and Utility Specifications and PAMC 14,05.050 regarding Electrical PerrritAppIcatons.
Signature of owner,elec;trilm contrackoror electric2l administrator: 0 Cash ❑ cbw*
C) —
kited,_j Z r 011012012
ELECTRICAL PERMIT
CITY OF PORT ANGELES �.
360-417-4735
Application Number 13-00001397 Date 12/05/13
Application pin number . . 671835
Property Address I .. . . . . 309 E 6TH ST REPORT SALE'S TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-1-9955-0000--
Application type description ELECTRICAL ONLY on your excise tax form
Subdivision Name . . . . . . to the City of Port Angeles
Property Use . . . . . (Location Code 0502)
Property Zoning . .. COMMERCIAL OFFICE
Application valuation . . . . 0
Application desc
3 circuits IOU- --------------- -- JAR ---
Owner Contractor
DAVE & MICHELLE O.LSON NORTH PENINSULA ELECTRIC
232 YELLOW ROCK LN 761 FRESHWATER PARK RD
PORT ANGELES WA 98362 PORE' ANGELES WA 98363
(360) 477-1795 (360) 477-1764
perma.t . . , . . . ELECTRICAL ALTER RESIDENTIAL,
Additional desc . .
Permit Fee 73.00 Plan Check Fee 00
Issue Date 12/05/13 Valuation . . . . 0
Expiration Date 6/03/14
Qty Unit Charge Per Extension
2,00 5,0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 10.00
1.00 63.0000 ECH EL-R- BRANCH CIR W01 SER FEED 63,00
------- --------_---- _----__--. __-_---------------------------. _____- c
Fee Summary - Charged j Paid -- Credited Due
Permit Fee Total 73,00 73.QQ .00 .00
Plan Check Total .00 .00 .04 .00
Grand Total 73,00 73.00 .00 .00
INSPECTION TYPE DATE: RESULTS.: INSPECTOR:
DITCH
SERVICE
ROUGH-IN Z v
FINAL !
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G:IEXCHANGEIBUILDING
PREPARED 5/04/11 8 23 41 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/04/11
ADDRESS 309 E 6TH ST SUBDIV
TENANT NBR THADDEUS AND AMY SMITH
CONTRACTOR AAWNINGS /SUNROOMS /DISTNCTN INC PHONE (360) 681 2727
OWNER THADDAEUS J AMY E SMITH PHONE (360) 477 2157
PARCEL 06 30 00 0 1 9955 0000
APPL NUMBER 10 00001184 RE ROOF
PERMIT
TYP /SQ
BL99 01
BNOP 00 BUILDING PERMIT NO PR FEE
REQUESTED INSP DESCRIPTION
COMPLETED RESULT RESULTS /COMMENTS
5/04/11
t�
BLDG FINAL
May 4 2011 8 22 17 AM 1pangrle
BRAD 461 2627
BUILDING FINAL RE ROOFED THE HOUSE GARAGE
COMMENTS AND NOTES
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
TEAR OFF RE ROOF THE HOUSE GARAGE
Owner
THADDAEUS J AMY E SMITH AAWNINGS /SUNROOMS /DISTNCTN
309 E 6TH ST 141 TIMBERLINE DR
PORT ANGELES WA 983626203 SEQUIM
(360) 477 2157 (360) 681 2727
Structure Information 000 000 RE ROOF THE HOUSE GARAGE
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Date Print Name
T.Forms /Building Division /Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
10 00001184
482048
309 E 6TH ST
06 30 00 0 1 9955 0000
THADDEUS AND AMY SMITH
RE ROOF
COMMERCIAL OFFICE
4150
Contractor
BUILDING PERMIT NO PR FEE
RE ROOF THE HOUSE GARAGE
175455
137 75
10/13/10
4/11/11
Qty Unit Charge Per
BASE FEE
3 00 14 0000 THOU BL -2001 25K (14 PER K)
Other Fees
Fee summary Charged Paid Credited
Permit Fee Total 137 75 137 75 00
Plan Check Total 00 00 00
Other Fee Total 4 50 4 50 00
Grand Total 142 25 142 25 00
re of Contr
Date 10/13/10
WA 98382
Plan Check Fee 00
Valuation 4150
Due
Extension
95 75
42 00
STATE SURCHARGE 4 50
00
00
00
00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
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 •rmisions of any state or local law regulating construction or the performance of
construction
3/ tig 13r0,0 l ve.- r
tor or Authorized Agent 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
Parking Lighting
Landscaping
Separate Permit #s
1
Electrical 417 -4735
Construction R W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
T:FormslBuilding Division /Building Permit
Inspection Type
IFINAL Date Accepted by
'FINAL Date
SEPA.
ESA.
SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
5 -LIA
Accepted by
Date Accepted By
3u-
Applicant s Ruc1/1
Property Owner T 4neoS 4 SMr119"
Property Owner's Address 6,
Contractor A- A- wnt oc,S 50• 15,V 09+1 n 4
Contractor's Address )i4 5 u
License ,ArlAviJ)14.99( DA- Expires 3 /J571 1
2r�
PROJECT ADDRESS
Parcel Number
Floor Areas Existina (sq. ft.)
Basement
1St Floor
2 Floor
3rd Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Total footprint of structures sq
Site Coverage the amount of impervious surface
and other impervious surfaces (see PAMC 17 94
Max. height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
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
309
Proposed (sq. ft.)
t size sq ft.
arcel including structures
for exemptions)
Occupancy group
Occupant load
onstruction type
Phone
Phone
For City Use Only
Date Received t6 1
Permit tIRLt
Date Approved
ziLi9
Phone efy —Z7Z7
E -mail f-So e Z, rz 4►L
Lot
Zoning
Project Type Brief Description. ){Residential Multi- family
Check all that apply
New Construction
Addition
Remodel
Repair
Demolition
?Re -roof )(House ,garage other Atear off re -roof lay over one layer
Heat System Heat pump wood- burning stove gas fireplace' pellet stove other
Other
Commercial Industrial
O TAL VALUATION
I have read and completed this application and know it to be true and correct. t am authorized to apply o permit and understand
that it is my responsibility to determine what permits are required, and to obtain permits prior to workin o pr e ts.
Date /bn2.--1/0 Print Name 1°
()C(4'? Signature
T Forms/Building Division/Bldg Permit.doc
per sq ft.
r 0e r l�cc1S
lit O r
of bedrooms
of full baths
o half baths
Lot coverage
driveways sidewalks patios
Site coverage
J
Clallam County Assessor Treasurer Property Details 57675 THADDAEUS J AND Page 1 of 5
Clallam County Assessor Treasurer
Property Search Results 57675 THADDAEUS J AND AMY E SMITH for Year 2010 2011
Property
Account
Property ID
Geographic ID
Type
Tax Area:
Open Space:
Historic Property
Multi Family Redevelopment: N
Township.
Range
57675
0630000199550000
Real
Location
Address. M 309 E SIXTH ST Mapsco
PORT ANGELES WA
Neighborhood: Cycle 5 Res Map ID
Neighborhood CD 10955130
Owner
Name THADDAEUS J AND AMY E SMITH Owner ID
Mailing Address: 309 E 6TH ST Ownership
PORT ANGELES WA 98362 -6203
Taxes and Assessment Details
Property Tax Information as of 10/13/2010
Amount Due if Paid on.
Legal Description.
Agent Code
0010 PA 121 PORT ST CNTY H2 L Land Use Code 11
N DFL N
N Remodel Property N
Section
Exemptions.
LT 12 BL 199 TPA
2
53185
100 0000000000%
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 r
Half Half
Base Base
Amt. !Amt. I Penalty I Interest Base Paid 4
$131 41 $131 41 $0 00 $0 00 $131 41
I Year Statement ID Taxing Jurisdiction
1 2010 40660 ST SCH STATE SCHOOL
2010 40660 CC -GEN COUNTY $69 94 $69 92 $0 00 $0 00 $69 94
2010 40660 PORT PORT �$9 83 $9 83 $0 00 $0 00 $9 83
2010 40660 PORT ANG PORT ANGELES $161 91 $161 92 $0_0_0 $0 00 $161 91
2010 40660 SD #121 SCHOOL DISTRICT #121 $170.21 $170.21 $0 00 $0 00 $170.21
2010 40660 NTH OLY LIB NORTH OLYMPIC LIBRARY $2 32 $20 32 $0 00 $0 00 $20 32
l 2010 40660 HOSP #2 HOSPITAL #2 $28 69 $28 69 $0 00 $0 00 $28 69
i 2010 40660 WSMET PK DIST WILLIAM SHORE MET PARK DIST $9 13 $9 13 $0 00 $0 00 $9 13
1 2010 40660 CITY_STORMWATER CITY STORMWATER $36 00 $36 00 $0 00 $0 00 $36 00
2010 40660 WEED CONTROL WEED CONTROL $0_82 $0 81 $0 00 $0 00 $0 82
2010 4 TOTAL. $638.26 $638.24 $0.00 $0.00 $638.26
2009 576752008 ST SCH STATE SCHOOL $149 46 $149 46 $0 00 $0 00 4 $298 92
i 2009 576752008 CC -GEN COUNTY $75 63 $75 65 $0 00 $0 00 $151.28
2009 576752008 PORT PORT $10 71 $10 72 $0 00 $0 00 $21 43
2009 576752008 PORT ANG PORT ANGELES $165 91 $165 91 $0 00 $0 00 $331 82
2009 576752008 SD #121 SCHOOL DISTRICT #121 $184 83 $184 82 $0 00 $0 00 $369 65
2009 576752008 NTH OLY LIB NORTH OLYMPIC LIBRARY $21 98 $21 98 $0 00 $0 00 $43 96
http. /vpn.clallam. net: 8084 propertyaccess /Property.aspx ?cid =0 &year= 2010 &prop_id =5 10/13/2010
tJ~
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~
~Wid"
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000371 Date
530327
309 E 6TH ST
06-30-00-0-1-9955-0000-
PLUMBING REPAIR
4/21/06
COMMERCIAL OFFICE
500
Owner
Contractor
CHAUSSEE, ADAM R/ANGELIQUE M
4016 NEWELL RD #13
PORT ANGELES WA 98363
OWNER
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date .
PLUMBING PERMIT
RPL H20 SERVICE FROM METER
75150
50.00 Plan Check Fee
Valuation
.00
o
10/18/06
Qty Unit Charge Per
BASE FEE
Extension
50.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 50.00 50.00 .00 .00
plan Check Total .00 .00 .00 .00
Grand Total 50.00 50.00 .00 .00
0hcz /
03 1t='J/
:2 V
8'() &-
~
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~
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1
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 as 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 goveming this type of work will be complied with whether s ecified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or. ocal law re lating construction or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
T:\Policies\1102_15 building pelTIlil inspection record05.wpd [1/412005]
/
"----
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES NO
FOUNDATION:
FOOTINGS
SHEAR WALLS I WALLS
FOUNDATION DRAINAGE I DOWN SPOUTS
PIERS
POST HOLES (POLE BLOGS.)
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE (METER TO BLOG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW I WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS I GIRDERS
SHEAR W ALLlHOLD DOWNS
WALLS I ROOF I CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL I FLOOR I CEILING
MECHANICAL
HEAT PUMP I FURNACE I DUCTS
GAS LINE
WOOD STOVE I PELLET I CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD I DUCTS
MANUFACTURED HOMES
FOOTING I SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARKING/LlGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R. W. I PW I CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 /" FIRE DEPT.
PLANNING DEPT. 417-4750 I PLANNING DEPT.
BUILDING 417-4815 ~ 'rJJ(/ oK III BUILDING
T:\Policies\J 102_15 building pennit inspection record05.wpd [1 41200~ ,
BUILDING PERMIT - APPLICATION
Date Issued:
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Phone:
-s
ArchitectlEngineer:
Contractor
State License #:
Phone:
Exp:
Phone:
Zip:
ZONING:
Address: . City:
PROJECT ADDRESS: 0i0 '1 G, ~ ~n S~
LEGAL DESCRIPTION: Lot:
CLALLAM COUNTY PARCEL NUMBER:
Block:
Subdivision:
TYPE OF WORK: SIZEN ALUATION:
o Residential. 0 New Constr. 0 Re-roof 0 Stove SF. @$ /SF. = $
o Multi-family D Addition 0 MoveD Garage SF. @ $ /SF. = $
o Commercial D Remodel 0 Demolition 0 Deck SF. @ $ /SF. = $
~ Repair D Sign 0 Other TOTAL V{.LUATION $ -S-uv
BRIEF DESCRIPTION OF THE PROJECT: ~\J\i \J,j\ J\~ \ 0 G---\{i\ ~ '\ V '\ (JL- ~()\f'I'v ~ \1./
~ h(l)\~
COMMERCIAL/RESIDENTIAL: Occupancy Group:
No. of Stories: --L Lot Size: S" ~~\LEXisting Sq. Ft.
Total lot coverage %
Occupant Load:
& Proposed Sq. Ft.
Construction Type:
= TOTAL Sq. Ft.
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant.
This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit
Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section
R105.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to
apply for this permit and understand that it is my responsibility to determine what permits are required ,not the City's, and that I
must obtain such permffs prior to WOrk}, .
T\FORMSlBWgPenni<fonn.wpd APPli'~./~/~( I; fi < ClM~ Date Y / J- I / () (e
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 16461
/:;;. - > ?b
Port Angeles, Washlngtonmm__mm_m__..hm____nmm.__..___.___mmm, 1900___000
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.
~::.:?t~~~~~;;;;;;_~'"":"'~~::::::::=
Wiring Contractor ooom________':J4oo_ooooooooooooooo_oooo___oom_ooh_noo_oo_oo By___oo_oo__ooooooo__oooooooooooooooooooo_____________oooooooooh_noo__
V /~O~~~
Light Outlets.....______...__.._............_.._.___. Service, volts .,...______........____...___......___
Receptacle Outlets.___......................_.... No. wires __.......1.__.........................
y/oJ
Size wires..................................._..
"~6A-
Main fuse .....__.___.......:.....___.._____.....
....
Enclosure ______...::?.....__......__........
Dryer, KW uuuu.....__...............__.._.______
Range, KW....nm.._..........:..
Water Heater:
KW_ooo_h___________nn___nUnU___UU_U_U
Heat: Kw.nr..1-flmu.L4..J_J_____m_mm
, '
Motors: sIze, volts and phase:
Type of wIring:
Entrance Cable ......___.
Rigid Conduit .m......................___..
Metallic Tubing ___.___m................_
Current transformers:
No. & Size............._.........................
Ser. No..................._............__............
Ser. No. ..........--..............--............__...
Ser. No.______.............____...__..__.__........__
Type 01 Wiring:
Armored Cable ..__.........___.__...........
Non.MetalUc .................................
Knob & Tube.....__....____...................
RIgid Conduit __un_m__U_oo_______oo_____
Metallic Tubing ____hm_u________oo_____
Raceway ...._.........................._._..._
Circuits, Light...__.....___.....___.__......__.......
Utility __u________________u________u_m___mu_
Heat ...__............._......._............_......
Range .............................................
Water Heater ......................__.......
Motor ..._...__......___.__...._...____.._........
Dryer__.._____..__..................................._
Furnace .........................._...................
Total wad............................. Ser. No. ...__......_______.._..~__..___.__...__.... Total __..__..__.._.____...__................
Remarks: ___oo__n____noo_..~,,~,!_~..d~oo4d"~~_h.~ooooooooooooooooooo___ooooooooooooooooooooooooooo_oooooooooooo___
,. -
_;::;~--;::----------noo--ooooooooo----;~~~~.oo~~~~;~~---___ooo-oooo-----nnoooooooooooooij;;-itJl::t::l-"--oooooooo
$00000__.0000.00000000000000_000_00000_ NOhooooooooooooooooooo.ooooooo By __/._!_!.ooooooo!oo___.'(ooooooooooooooooooo___ooZ_n~_~oo
v
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work Is to be con-
cealed due notice must be given the Inspector so that ""ork may be Inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N?
16461
Address................................................................................................._......................................Date..._......_.._......_.................._......._..._.....
Owner..........._........_._............_....._...._.............._.._..............................__...........................Tenant.........._.................................................._......
WiringContractor..................................._......................_.................._..............._..........................By........................._........................_..._.......
NOTICE--Current must not be turned on untU Certlt1cate ot Inspection has been Issued. It work Is to be con-
cealed due notice must be given the Inspector so that work may be inspected betore concealment.
'\?-
/ '
~ -. ~'-'- ......,_..;._~ T..,.. ........