HomeMy WebLinkAbout505 E 6th St - BuildingPREPARED 12/13/10 8 46 52 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 12/13/10
ADDRESS 505 E 6TH ST
TENANT NBR JACK R LUND
CONTRACTOR ALL WEATHER HTG COOLING INC
OWNER JACK R LUND
PARCEL 06 30 00 0 1 9750 0000
APPL NUMBER 10 00001304 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESUL71 RESULTS /COMMENTS
ME99 01 12/ 3
SUBDIV
PHONE (360) 452 9813
PHONE (360) 457 4678
MECHANICAL FINAL TIME 01 00
December 13 2010 8 42 09 AM 1pangrle
JENNY (ALL WEATHER HTG 452 9813)
MECHANICAL FINAL HEAT PUMP
AFTERNOON
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
INSTALL A DUCTLESS HEAT PUMP
Owner
JACK R LUND
505 E 6TH ST
PORT ANGELES
(360) 457 4678
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge
1 00 14 8000
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
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
WA 983626207
MECHANICAL PERMIT
DUCTLESS HEAT PUMP
176982
64 80
11/05/10
5/04/11
BASE FEE
EA ME FURN /HP /FAU OR 5
Per
Charged
64 80
00
64 80
10 00001304
282768
505 E 6TH ST
06 30 00 0 1 9750 0000
JACK R LUND
MECHANICAL APPL PERMIT
RESIDENTIAL HIGH DENSITY
5856
Paid
164 80
00
164 80
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 Inot 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.
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
Contractor
Plan Check Fee
Valuation
Credited
TON
00
00
00
Date 11 /05 /10
ALL WEATHER HTG COOLING INC
302 KEMP ST
PORT ANGELES WA 98362
(360) 452 9813
Due
00
00
00
00
0
Extension
50 00
14 80
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
0,0
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.
T:Forms /Building Division /Building Permit
FINAL Date Accepted by
FINAL Date 1 7 5 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
BUILDINg PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES
Attn: Building Permit Technician
321 E. Fifth St. Port Angeles, WA 98362
x (3360) 417 -4815 fax (360) 417 -4711
Applicant k QO 1C vvc CCG
Property Owner k \d
Property Owner's Address F. Ct
Contractor 1 Ct 11;
Contractor's Address
License Expires WI 1 111
PROJECT ADDRESS
Parcel Number
erect Tripe Brief Descriotion; 1Residential a Multi- family a Commercial a Industrial
Check all that apply
o New Construction
,o Addition
*Remodel
a Repair
u Demolition
o Re -roof a House a garage a other a tear off re -roof a la x over one layer
Heat System Heat pump a wood- burning stove a gas fireplace a pellet stove Xother du(
a Other
Floor Areas
Basement
1' Floor
2 Floor
3` Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Z0 /Z0 39t'd
Existing (sa. fL) Pn osed (sa. ft.)
SNI1v3H i'13H1■3t 11d
Lot
For City Use Only
Date Received 1A-5.- i0
Permit 1O -.130
Date Approved
Phone
Phone t -�o IZS
c
Phone ad) LZ GiF�l3
E -mail G CC
per sq. ft.
TOTAL VALUATION
Total footprint of structures sq. ft. T 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
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
I have read and completed this application and know it 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, and to obtain permits prior to w on rojects.
Date \\41rD Print Name n\ Signature
1':Forms/Bullding Division /Bldg Permit.doc
Zoning
of bedrooms
of full baths
of half baths
LLISZSb0' EI 8E 80 0i02 /90 /ti
Clallam County Assessor Treasurer Property Details 57645 JACK R LUND for Yea. Page 1 of 5
Clallam County Assessor Treasurer
Property Search Results 57645 JACK R LUND for Year 2010 2011
Property
Account
Property ID 57645 Legal Description LOT 11 BL 197 TPA
Geographic ID 06300001975 )0000 Agent Code
Type Real
Tax Area: 0010 PA 12' 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: 505 EAST SI) ;TH ST Mapsco
PORT ANGE .ES WA 98362
Neighborhood: Cycle 5 Res Map ID 2
Neighborhood CD 10955130
Owner
Name. JACK R LUND Owner ID 38003
Mailing Address: 505 E 6TH ST Ownership. 100 0000000000%
PORT ANGELES WA 98362 -6207
Taxes and Assessment Details
Property Tax Information as of 11/05/2)10
Amount Due if Paid on. M.
Exemptions.
Year Statement ID Taxing Jurisdiction
2010 40630 ST SCH STATE SCHOOL
2010 40630 CC -GEN COUNTY
2010 40630 PORT PORT
2010 40630 PORT ANG PORT ANGELES
2010 40630 SD #121 SCHOOL DISTRICT #121
2010 40630 NTH OLY LIB NORTH OLYMPIC LIBRARY
2010 40630 HOSP #2 HOSPITAL #2
2010 40630 WSMET PK DIST WILLIAM SHORE MET PARK DIST
2010 40630 CITY STORMWATER CITY STORMWATER
2010 40630 WEED_CONTROL WEED CONTROL
2010 40630 TOTAL:
2009 576452008 ST SCH STATE SC
2009 576452008 CC -GEN COUNTY
2009 576452008 PORT PORT
ANGELES
2009 576452008 PORT ANG PORT ANGELES
77-
2009 576452008 SD #121 SCHOOL DISTRICT #121
2009 576452008 NTH OLY LIB NORTH OLYMPIC LIBRARY
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
I Half Half
Base Base
Amt. Amt. Penalty Interest Base Paid p
$170 88 $170 88 $0 00 $0 00 $341 76
$90 94 $90 93 $0 00 $0 00 $181
$12.78 $12.78 $0 00 $0 00 $25 56
$210 55 $210 55 $0 00 $0 00 $421 10
$221 32 $221 34 $0 00 $0 00 $442.66
$26 42 $26 43 $0 00 $0 00 $52.85
$37 30 $37 31 $0 00 $0 00 $74 61
$11 87 $11 87 $0 00 $0 00 $23 74
$36 00 $36 00 $0 00 $0 00 $72.00
$0 82 $0 81 $0 00 $0 00 $1 63
$818.88 $818.90 $0.00 $0.00 $1637 78
$195 52 $195 52 $0 00 $0 00 $391 04
$98 95 $98.95 $0 00 $0 00 $197 90
$14 02 $14 01 $0 00 $0 00 $28.03
$217 05 $217 03 $000 $0 00 $434 08
$241 79 $241.81 $0 00 $0 00 $483 60
$28 75 $28 75 $0 00 $0 00 $57 50
http. /vpn. clallam. net: 8084 /propertyaccess/Property. aspx ?cid =0 &year= 2010 &prop_id =5 7 11/5/2010
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Ductless heat pump
Owner
LUND JACK R
505 E 6TH ST
PORT ANGELES
WA 983626207
Permit ELECTRICAL HEATPUMP
Additional desc
Permit pin number 176479
Permit Fee 78 70
Issue Date 11 /01 /10
Expiration Date 4/30/11
Fee summary
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST
Signature of owner or Electrical Contractor X
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
10 00001266
242860
505 E 6TH ST
06 30 00 0 1 9750 0000
ELECTRICAL ONLY
RESIDENTIAL HIGH DENSITY
0
Contractor
SIMPSON ELECTRIC
243036 W HWY 101
PORT ANGELES
(360) 457 9270
Plan Check Fee
Valuation
Qty Unit Charge Per
1 00 73 5000 ECH EL BRANCH CIRCUIT WO /FEEDER
2 00 2 6000 ECH EL ECH ADDNT BRANCH CIRCUIT
Charged Paid Credited
Permit Fee Total 78 70 78 70 00
Plan Check Total 00 00 00
Grand Total 78 70 78 70 00
1
DATE.
61t5iti
NSPECTION
Date 11 /01 /10
RESULTS
WA 98363
00
00
00
00
0
Extension
73 50
5 20
Due
c°14)
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTOR.
Date.
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division /Electrical Inspections
321 East Fifth Street P.O. Box 1 Angeles Washington, 98362
Ph (360) 417 -4735 Fax: (360) 417 -4711
Date: 9
1 2 Single Family Dwelling Multi- Family or Commercial*
Plan Review May Be Required, Please Complete Electrical Elan Review Information Sheet
i
Job Address; »'GK� L(M CO_ g
Building Square Footage;
Description of above 410 1.ijri :r o i ie
7
Owner Information
Name: Luvlr
Mailing Ad ss: O S
City. Pig State: A„ ZIP: 1 fB.3,k�
Phone:J m i o Fax:
License Exp,
Item
Service /Feeder 200 Amp.
Service /Feeder 201 -400 Amp.
Service/Feeder 401 -600 Amp
Seance /Feeder 601-1000 Amp.
Service /Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O 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
Sign /Outline Lighting
Signal Circuit/ Limited Energy First 1500 sf Commercial
Note: $5,00 for each additional 1500 sf
Signal Circuit/ Limited Energy 18 2 Family Dwelling
Signal Circuit/ Limited Energy Multi- Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
Thermostat
NEW CONSTRUCTION ONLY:
First 1300 Square Ft,
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
of wner electrical contra or electrlcil administrator'
Unit Charge
$119.90
$145.50
204.60
262.20
372.50
2.60
73,50
2.60
92.70
$110.30
148.70
167.90
95.90
88.20
95,90
63.90
63.90
$119.90
$102.30
56.00
$110.30
35,20
73.50
$110,30
Dated:
f e 2
Commercial Addition Alteratior Remodel Repair*
Contracto Info a
Name:
Mailing A
City'
Phone;
License
2-
Ceeh Check
p NCred t Card 0 6 1' 1
^ter
j 0
OCT 2 r(g, Er-- -'V
ELECTRICAL 1 ""r
INSPECTIONS
i 'dAd f lee ie. 14,e
State: _A:
Total Multi oiled by Unit Charge)
s3 74 1 Total
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 ror 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 cant actor I am making
the electrical installation or-alteration in compliance with the electrical laws, N.E.C. RCW Chapter 19.28, WAC, Chapter 296-485, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14.05,050 regarding Electrical Permit Applications.
0110112010
I
I
ti
,.
11::. --
~~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, W A 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
07-00000118 Date
323566
505 E 6TH ST
06-30-00-0-1-9750-0000-
JACK LUND
RE-ROOF
2/02/07
~
-.....J
t
-
~
RESIDENTIAL HIGH DENSITY
6780
Owner
Contractor
LUND JACK R
505 E 6TH ST
PORT ANGELES
WA 983626207
RAINMASTER ROOFING
1205 S. 0 ST.
PORT ANGELES WA 98362
(360) 452-3213
permi t . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT - NO PR FEE
TEAR-OFF, COMP, FELT
94573
165.75 Plan Check Fee
2/02/07 Valuation
8/01/07
.00
6780
Qty Unit Charge Per
Extension
95.75
70.00
BASE FEE
5.00 14.0000 THOU BL-2001-25K (14 PER K)
Other Fees
STATE SURCHARGE
4.50
er,
\:>
'1
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 165.75 165.75 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 170.25 170.25 .00 .00
\C(
~
}
I
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~ ,,<J ~
;.;; '77
~
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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
taws 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.
__ 2-2....-0
Authorized Agent Date
Signature of Owner (if owner is builder)
Date
T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005]
'----
BUll..DING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-47~5 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS liTILITIES
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 LOCATlON.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
I
YES NO
FOUNDATION:
FOOTINGS
SHEAR WALLS 1 WALLS
FOUNDA nON DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.) .
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDGl
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALUHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (rNTERJOR BRACED PANEL ONL Yl
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
ROUGH-IN
HEATP~/FURNACE/DUCTS I
GAS LINE FINAL DATE ACCEPTED BY:
WOOD STOVE 1 PELLET 1 CHIMNEY
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKJRTING
PLANNING DEPT. SEPARATE PERMlT#'s SEPA:
PARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRlCAL - LIGHT DEPT. 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R. W./PWI CONSTRUCTION - R. W.
ENGINEERJNG 417-4807 PW 1 ENGINEERJNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:IPoliciesl 1102 15 building pennit inspection record05.wpd [1/412005]
,-----
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BUILDING PERMIT - APPLICATION
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)417-4 711
Applicant or AgentP..,,,..,-J1IItkk,. ~J
Owner: ~c_k LlVd
Address: bOS &. Six.J..
Architect/Engineer:
Contractor "R41A1-MdS..,...,.
r )
Address: /205' SO<l~./"O
PROJECT ADDRESS: ~OS E. b #.
LEGAL DESCRIPTION: Lot
CLALLAM COUNTY PARCEL NUMBER:
City: 7? ,4.
Phone: liS;;' -32.13
Phone: 'I:I7-<f~78
Zip: <1B3~2-
Phone:
State License #: ~IAlMIl~O ~CJ-lV1k Exp: 10-28-08 Phone: <tSZ-3"l../3
City: 7? A.
Zip: 9BJ€ 3
ZONING:
Block:
Subdivision:
TYPE OF WORK:
~ Residential D New Constr. _, Re-roof D Stove
D Multi-family D Addition D MoveD Garage
D Commercial D Remodel D Demolition D Deck
D Repair D Sign D Other
BRIEF DESCRIPTION OF THE PROJECT:
SIZEN ALUATlON:
SF. @ $ /SF. = $
SF. @ $ /SF. = $
SF. @ $ /SF. = $
TOTAL VALUATION $ '780~
COMMERCIAL/RESIDENTIAL: Occupancy Group:
No. of Stories: Lot Size: Existing 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): DYes D No SEPA Checklist required? DYes D 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: Ifno 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 permits prior to work. .
Date: ;2-;1.-07
T:\FORMS\BldgPennitform.wpd Applic
\.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
PERMIT NO. 30 rP c:.....
.,s--/& ~'?/
DATE
Installed By:
SD.s f'.
~A
"
o READY FOR 0 WILL CALL FOR
INSPECTION INSPECTION
License Number: Phone:
Site Address:
OwnerfBusiness:
Phone:
OwnerfBusiness Address:
Sq. Ft.
'J(]) Residential
r Heat KW
o Baseboard 0 Furnace/Boiler
o Heatpump 0 Other
o Commercial/lndustriai load
Total Connected load
(attach breakdown)
Total Motor load
(attach breakdown)
o New Construction
1sl Remodel
o Service update/alter/repair
k(Add/alter circuits
o Auxiliary power
(list below)
o Special equipment
(list below)
o Overhead
o Underground
Voltage
010 03.0
Service size
o Temporary
Amps
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Detai I s/Descri pt ion:
.IVI
W.S. No. Service
Capacity: 0 O.K. 0 Not O.K.
o Ditch inspection O.K.
~ Rough-in/cover O.K.
o O.K. to connect service
o Final O.K.
Size
Comments
Date
Hold for: 0 Easement 0 Letter
o Signed up for service/meter
o Meter Department notified for instaliation
o Fire Department notified of inspection
o Plan Review approved/pending
Site Address;
S&.s (. {; ~
Permit/Receipt No.
;] og c.
Installer:
New Meters
Date:
S- -If)-r
.
Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work
must not be covered or electricaliy energized before inspection and O.K. for covering or service has been given
by the Inspeg1o/:-ifl Writing on the Wiring Report or the Building Permit. PHONE 457-0411, EXT. 158 or EXT. 224.
~ ! ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ~
Inspector Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
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