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Home My WebLink About1721 W 7th St - Building Building Permit 1721 W 7", St 12- 1271 PREPARED 12/12/12, 12:54:37 INSPECTION HISTORY REPORT PAGE 1 PROGRAM BP521L 0/00/00 THRU 0/00/00 CITY OF PORT ANGELES ------------------- APPLICATION PROPERTY ADDRESS ASSESSOR PARCEL NUMBER ALTERNATE ID STRUCTR PERMIT INSPECTION RESULT DATE/STATUS INSPECTOR ------------------------------------------------------------------------------------------------------------------------------------ 12 00001271 1721 W 7TH ST 06-30-00-0-1-4970-0000- 063000014970 000 000 ME 00 MECHANICAL PERMIT ME99 0001 MECHANICAL FINAL 10/08/12 CANCELLED JLL REQ COMM: October 8, 2012 8:27:52 AM pbarthol. REQ COMM: Dave 461-0471 REQ COMM: ** Call Dave so he can meet you there to unlock the house. REQ COMM: early afternoon. before 1:00 if possible. *** RES COMM: October 8, 2012 4:09:52 PM jlierly. RES COMM: Canceled by contractor/jll 000 000 ME 00 MECHANICAL PERMIT ME99 0002 MECHANICAL FINAL 10/10/12 APPROVED JLL REQ COMM: October 10, 2012 8:36:27 AM pbarthol. REQ COMM: Dave 461-0471 REQ COMM: Call Dave 1st so he can meet you there and unlock the house. RES COMM: October 10, 2012 4:31:12 PM jlierly. CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 12-00001271 Date 9/28/12 Application pin number . . . 610730 Property Address . . . . . 1721 W 7TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-1-4970-0000- REPORT SALES TAX Application type description MECHANICAL APPL. PERMIT Subdivision Name on your state excise tax form Property Use to the City of Port Angeles Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY. Application valuation . . . . 6225 (Location Code 0502) -------------------------------- Application desc HEAT PUMP ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ RUSS & PAMELA MORRISON DAVE'S HTG & COOLING SRVC INC 1721 W 7TH ST PO BOX 413 _ PORT ANGELES WA 983635203 PORT ANGELES WA 98362 (360) 452-0939 ---------- Permit . . . . . . MECHANICAL PERMIT Additional desc . Permit Fee . . . . 64.80 Plan Check Fee .00 Issue Date . . . 9/28/12 Valuation . . . . 0 Expiration Date 3/27/13 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 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 an state or local law regulating construction or the performance of construction. 21 Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Bui[ding Division/Building Permit • tip. 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 INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB S7E. \ V 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 Bid 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: Z Slab Wall/Floor/Ceiling o MECHANICAL: Heat Pum /Furnace/FAU/Ducts Rough-In Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted by MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parkin /Li htin ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type Date Accepted By t Electrical 417-4735 n Construction- R.W. PW /Engineering 417-4831 Fire 417-4653 �. Planning 417-4750 Building 417-4815 Ae / I— 1 C, TC.,rmolR nBrifnn fli.ic inn/R nilrlinn Pormit 09/26/2012 11 '.24AM FAX U0001/0001 ��ir°"r^'� BUILOIl�G PERMIT APPLICATION Print in ink ��. CITY OF PORT ANGELES , mar-- Attn: Building Permit Technician - For City Use Only: ^ter 321 E. Fifth St,, PortAngelas,WA 98302 Date Received�� (360)417-4815 fax(360)417-4711 Permit#_ iZ� lZ'i L Date Approved__ q- 7-1,j, Applicant a (.5 ?ra_ Phone S� Property Owner _ ,z or^ so Phonep..3a Property Owner's Address Contractor � Phone Contractor's Address 62. License# G, -Exp its E-mail PROJECT ADDRESS Parcel Number Lot zoning Project Type & Brief Descr„ptlon, asidential a Multi-famlly b Commercial ❑fidustrlal Check all that apply ❑New Construction o Addition ❑Remodel o Repair a Demolition ❑Re-roofv House o garage o other `- o tear off&re-roof a lay over one layer Heat System Haat pump ❑wood-burning stove a gas fireplace o pellet stove o other a Other Floor Areas Exisffng(sa. ft.) 'Progosed(sq, ft.) Basement @$ 1" Floor per sq. ft. _$ 2nd Floor 3'd Floor Garage Carport `— Covered Porch Deck . • - Shed Other rOTAL VALUATION $ To!al 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 exermptlons) Site coverage % Max. height of proposed structures ft. Occupancy group #of bedrooms Will a lawn sprinkler system be installed? Occupant load #of full baths Will a fire sprinkler system be installed? Construction type #of half ba`.hs !havo road and completed this application and know it to be true and correct t am authorized to aaply for this parmit and understand that it is my resporylbilitY to delerrnlne whal perm/its are requirud and to obtain permits prior to rki on pro/acts. Date rint Name_41:6 a m0 Signature i:Form° UlIding �iyVi,,Cin11B3uildlng perrnli appl7cation Electrical Permit 172 ] W 7th St 12- 1265 12- 1324 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 12-00001265 Date 9/27/12 v 1 Application pin number . . . 797185 l Property Address . . . . . . 1721 w 7TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-1-4970-0000- on your excise tax form Application type description ELECTRICAL ONLY Subdivision Name . . . . . . to the City of Port Angeles Property Use . . . . . . . . (Location Code 0502) Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 Application desc T-stat HP ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ RUSS & PAMELA MORRISON DAVE'S HTG & COOLING SRVC INC 1721 W 7TH ST PO BOX 413 PORT ANGELES WA 983635203 PORT ANGELES WA 983//62 (360) - 39 ---------------- ------------ ------------ --- -- -��JZY----- Permit . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . Permit Fee . . . . 56.00 Plan Check Fee .00 Issue Date . . . 9/27/12 Valuation . . . . 0 Expiration Date . . 3/26/13 i Qty Unit Charge Per Extension 1.00 56.0000 ECH EL-LVT-THERMOSTAT 56.00 ----------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 56.00 56.00 .00 .00 C Plan Check Total .00 .00 .00 .00 1\/J Grand Total 56.00 56.00 .00 .00 V INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN Z FINAL COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGE\BUILDING oFPORTgA,, ELECTMli L �IJ�J�Lf LS��OIIV REPORT xs& 417-4735 cwoaS�` DATE: PERMIT# INSPECTOR b LZ-- OWN 32,I`` Yq ►' CONTRACTOR V►�yes�C�t�- f< Co�"��6k ADDRESS '�l l APPROVED NOT APPROVED ❑ . . . . . . . . . . . . . . . . . . . . DITCH . . . . . . . . . . . . . . . . . . . . ❑ ❑. . . . . . . . . . . . . . . . ROUGH IN/COVER . . . . . . . . . . . . . .lj;,� ❑. . . . . . . . . . . . . . . . . . . . SERVICE . . . . . . . . . . . . . . . . . . . ❑ . . . . . . . . . . . . . . . . . . . . FINAL . . . . . . . . . . . . . . . . . . . . ❑ CORRECTIONS NEEDED: _L /"I.C. 5 H h LL. r,tt-- S-M}� FLY-n.C. Sid 14G Ai SZrFtLLFt� LaV.,t L IF— 01:- �►�k�/G74i . J Iz- NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHON 95 DAYS ® 00 NOT REMOVE 09/26/2012 11 :28AM FAX 190001/0002 Jv VIE)RY City of Port Angeles Permit Application �� 1C Building DlvlslonlElectrical Inspections 321 East Fifth Street-P.O.Box 11SO 2r G Port Angeles Washington 98362 Ph:(360)417413 Fax:(360)417.4711 ? ELLG'i Date: N I IGv, If A&2 Single Family Dwelling ultl-Family or Commercial' Commercial Addition/Alteration I Remodel./Repair' Plan Review May Be Required,Plea a Complebe I trical PI n RWfbrmqtiop Sheet Job Address; Building Square Footage: /1-r GaSC-3 - Description of a ve vo a ,�� r►.,�, Owner Inf allon tractor Irrfor�natio , Name: �S6 Name: Mailing dress: Mallin ddres City: at Zip: City: d late: Zi : P Phone. Z Fax: Phone: Fax: License Ft/Exp. License )Exp. nit ChaEga Total(Qty Mul(lplled by Unit Charge) $119.90 $—,—Service/Feeder 200 Amp, $145.50 _ $ ServlcelFeeder 201400 Amp. $204.60 $ ServiceiFeeder401-600 Amp. $262.20 S _ Service/Feeder 601.1000 Amp. $372.50 $-- ServicelFeeder over 1000 Amp. $ 2.60 $____Branch Circuit W1 Service Feeder $ 73.50 $ Branch CirtuitW/0 Service Feeder $ 2.60 $ _Each Additional Branch Circuit $ 92.70 $_,__Temp.Servicel'Feeder 200 Amp. $110.30 _ $ Temp.Service/Feeder 201-400 Amp. $148.70 $ Temp,Servlce/Feeder401-600 Amp. $167.90 $ Temp.Service/Feeder 601-1000 Amp. $ 95.90 _ $ Portal to Portal Hourly 3 88.20 $ SigNOutline Lighting 3 95.90 $ Signal Circuit/Limited Energy-Commercial.Additional 1500$5.00 $ 63.90 $ Signal Circuit/Limped Energy-1&2 Family Dwelling $ 63.90 $ Signal Circuit/limited Energy-Multi-Family Dwelling $119.90 $___, Manufactured Home Connection $102.30 5 .w Renewable Electrical Energy-51( System or Less $110.30 ,_ $ First 1300 Square Ft $ 35.20 $ Each Additional 500 Square Et.or Portion of S 73.50 $ Eath Outbuilding or Detached Garage $110.30S^,_. Each Swimming Pool or Hot Tub S 58.00 $ hwmostat $Total Owaar as defined by RCW.19.28.281:(1)Owner wi f occupy the structure rot two years after this,electrical permit 19 finalised.(2)Owner Is squired fo hire on electrical contractor H above sa/d propenyls forsale,rant or lease.Permit expires aftersfxmonths of last inspection. After reading the above statement,I hereby certify that i am the ownerof the above named property or a licensed electrical contractor.lam making the electrical Installation or alteration In compliance with the electrical laws,N.E.C.,RCW.Chapter 19.28,WAC.Chapter 298488,The Clty of PortAngelee Municipal Code,and Utility Specifications. Signature of owner,electrical Contractor or electrical administrator CJ Cash O Check �� eCrdltC8rd# N ELECTRICAL PERMIT ;= CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 12-00001324 Date 10/09/12 Application pin number . . . 038228 Property Address . . . . . . 1721 W 7TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-'0-1-4970-0000- on your excise tax form Application type description ELECTRICAL ONLY Subdivision Name . . . . . . to the City of Port Angeles Property Use . . . . . . . . (Location Code 0502) Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 1 circuit Heat .Pump --------------------------------------------------------------------------- J Owner Contractor RUSS & PAMELA MORRISON EXTRA MILE TECH & ELECT., .LLC 1721 W 7TH ST 418 N. RACE ST. PORT ANGELES WA 983635203 PORT ANGELES WA 98362 (360) 457-0198 * ` ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . . Permit Fee . . . . 63.00 Plan Check Fee .00 Issue Date . . 10/09/12 valuation 0 Expiration Date . . 4/07/13 Qty Unit Charge Per Extension 1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 63.00 63.00 .00 .00 (� Plan Check Total .00 .00 .00 .00 V/' Grand Total 63.00 63.00 .00 .00 ,Q INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN FINAL ` COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGE\BUILDING _ N ro O� 1 CffY OF PORT.ANGELES PERMrr APPLICATitoN � v ELECTRICAL BuRding IDivisioaMlecttrical Inspections 321 East Fifth Street-P.O.Boa 1150/fort Anger Washington,48362 6NSPECTINSPECTIONS ez t - ]Ph:(360)417-4735 Fax:(360)4174711 Date: /Z L' 1&2 Single Family Dwelling 9 Y 9 Plan Review May Be Required,Please Complete Electrical Pian Review Information Sheet Job Address: /2_21 Building Square Footage: Description of above i�y �,Y r/ /✓tom tv�,.� �.2 �y�f ��Lt;,,,� Owner information Contractor Information Name: s tYL v 2 Ir—s Name-. R L4-8 d-r Acczj Mailing Address: i w'. r�- Mailing Address: City 7, .F n State e,/i Zp: 1 Y 3/.3~ Ciiy: V-ti- sfate.'I,!i�1— Zip: S(z L Phone; Fax: Phone�fx 7—52 Fax_ �7 License#f Exp. License#/Exp. cx,6/L/FM r 473P ft n Unit Chante Qty Total(Qty Multiplied by Unit Charnel ServkWFeeder 200 Amp- $120.00 $ Service/Feeder 201.4W Amp- $146.00 $ ServicelFeeder 401-600 Amp $205.00 $ Servioeffeeder 601-1000 Amp. $262.00 $ Service/Feeder over 1000 Amp. $373.00 $ Branch Circuit W/Service Feeder $ 5,40 $ Branch Ciraiit W10 Service Feeder $ 63.00 Each Additional Branch Circuit $ 5.00 $ Branch Cinuits 1-4 S 75.00 $ Temp.Service!Feeder 200 Amp. $ 93.00 $ Temp.Service/Feeder 201-400 Amp_ $110.00 $ Temp.Service/Feeder 401.600 Amp. $149.00 $ Temp.SeroicelFeeder 601-1000 Amp- $168.00 $ Portal to Portal Hourly $ 96.00 $ Signal Circuit/Limited Energy-18 2 Family Dwelling $ 64.00 $ Manufactured Home Connection $120.00 $ j Renewable Electrical Energy-5KVA System or Less $102.00 $ Thermostat $ 56.00 $ Note:$5.00 for each additional T-Stat NEW CONSTRUCTION ONLY.- First NLY:Fust 1300 Square Ft $120.00 $ Each Additional 500 Square FL or Portion of $ 40.00 $ Each Outbuilding or Detached Garage $ 74.00 $ Each Swimming Post or Hot Tub $110.00 i —Total Owner as defined by RCW.19.28.261:(1)Owner will occupy the structure fortwo years after this electrical pen-nit 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. C After reading the above statement,I hereby certify that tam 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 296468,The City of Port Angeles Municipal Code,and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications, Signature of owner,efect ical contractor or electrical administrator. ❑ cash ❑ pedc Q aedffitc:gd= x ,,,.E ,o Paftd. o�roum�z I OF D,ORT4,,, �' iCITY OF PORT ANGELES � LIGHT DEPARTMENT -71[0PERMIT NO. /o,, ELECTRICAL PERMIT DATE Site Address: �-y /, , y�(p ❑ READY FOR -WILL CALL FOR OG �/t/ , ` INSPECTION //``INSPECTION Installed By: r License Number: Phone: lfvi,t c , 1s'a— 706 9 OwnerlBusiness: Phone: Owner/Business Address: Sq. Ft. Residential ❑ New Construction ❑ Overhead Heat KW ❑ Remodel ❑ Underground/ if� ElBaseboard ❑ Furnace/Boiler Service update/alter/repair Voltage //� Y F1Heatpump ❑ Other 4710 ❑ 30 ❑ Commercial/Industrial load ❑ Add/alter circuits Service size Amps Total Connected load ❑ Auxiliary power ❑ Tempora l (attach breakdown) (list below) POy Total Motor load ❑ Special equipment (attach breakdown) (list below) Details/Description: n W.S. No. Service Size—Date—Hold for: ❑ Easement ❑ Letter Capacity: ❑ O.K. ❑ Not O.K. Co ments ❑ Ditch inspection O. '��^� � �''''"""" ElSigned up for service/meter qA 0 Rough-in/cover OX El Department notified for installation hey O.K. to connect se 'ce ❑ Fire Department notified of inspection Final O.K. y�� g� ❑ Plan Review approved/pending Site Address: , Permit/Receipt No. /;I/' Installer: New Meters Date:/ Afe � l�0^ p Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Inspector in 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 (9_0 Inspector Amount paid WHITE—file by address YELLOW—file by number PINK—Top:Eng,Bottom:Customer GREEN—Top:Inspector,Bottom:City Hall OLYMPIC PRINTERS. INC. I CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT _N`.' 17022 Port Angeles, 119Washington---------- CPO ----------- 19.0.7 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 electric work as listed below. Address : 40!�A_l............ Occupancy- ---------------------•--- Owner - ' � _M... Tenant.---•--•----••--••--------------- WiringContractor--- c e.- --------------------- By----------------------------------------- ---------------------- Light Outlets..._.........................._.._..... Service, volts /vi. ../ G..,. Type of Wiring: Receptacle Outlets............................... No. wires .....-----__'---_--------------/^.._ Armored Cable ...._....................... Dryer, KW.......................................... Size wires....�j � Non-Metallic ................................. Range,KW.--------'-'-"--'-----'--------- Main fuse ----.��Q..p_�....... Knob & Tube................................. ................... Rigid Conduit ..........................._._ Water Heater: Enclosure .................... Metallic Tubing ........................... KW........... ..... ....CC.y....Q..._... Type of wiring: Raceway ......................._..... ___._ Heat: KW...._�.1.t5 .r Z_1---...... Entrance Cable ............................. Circuits, Light....... Motors: size, volts and phase: Rigid Conduit ............................... Utility ...----------------------....--.............. ........................................................... Metallic Tubing ...._..................... Heat ......................._..................... Current transformers: Range ...:..........I......_......._.............. ..............................._.......................... No. & Size....................................... Water Heater ............................... Ser. No............................................... Motor ..--.................................... Ser. No---------------------------------------------- Dryer----------------------------------------------" ........................................................... Furnace Ser. No.............................................. TotalLoad....... ... " . No............................................ t Total ....................................... Remarks: -------- '= -- rsems ------------------------ -----•---------------------------------•-----------------•--•--------.........-------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------ ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------- / i111 / / Permit Fee Treas. Receipt �� f �� -------------. No ................. / ./Lr ..-� .:�'__•'-'�" 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 work may be Inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION , _•, ELECTRICAL PERMIT No 17022 h ` �Address ............................................................................................ Date..................................................... Owner ..................................._....................................................................................... Tenant..................... ....................... jWiring Contractor..........................................................._...................................................-........ By............................. 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 work may be inspected before concealment. 4 - 1M Olympic Printers, Inc. 44 ( \ CITY OF PORT ANGELES LIGNT DEPARTMENT ELECTRICAL PERMIT N° 16 0 9 Port Angeles, Washington------ y ---•---- 19-------' 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. � cJ r- Address - -'-'--"--f- ---------------�-- ---------------------------- ------- Occupancy-------- = -----------------------•-•- Ownere'.:.-.. ,l- `�r------------------ Tenant--------------------------------------------------------•-•- ---•------- Wiring Contractor == -------------------------------------------------------- By----------------------------------------•---------------------------- � r Light Outlets....................................... Service, volts ---------- ...... Type of Wiring: Receptacle Outlets............................... No. wires ._1ll........._ -....... Armored Cable ...._..................-...- .............. , Dryer,KW................'-"--'- �/�fr'+ • Non-Metallic .........._...............-'--- "----`-------- Size wires................:.................._. l!p 0,4- Knob & Tube.........-- - --_-.......-. Range, KW.............._....._....._._......... Main fuse ...:f..,..._...._................... Water Heater: i` Rigid Conduit ............................... Enclosure Rigid ..------ ........................... Metallic Tubing ................-.......... KW. -----------------_.._.--- Type of wiring: Raceway .....................................- Heat: KW................................................... Entrance Cable............................. Circuits, Light-----------............................ Motors: size, volts and phase: Rigid Conduit ...------------_-............ Utility ------.......-_....._.................... ........................................................... Metallic Tubing -----------------......... Heat ---------------------------------------------- Current transformers: Range ........................................ ----------------------------------------------------------- ..... No. & Size....................................... Water Heater ..............-................ ........................................................... Ser. No............................................... Motor ............................................. ---"------.....".........................._..._-...... Ser. No.............................................. Dryer................................................_ -------------------------------------------------------"• Furnace..........................-. Ser. No.............................................. TotalLoad-----------------------.... Ser.No.................._.......................... Total ....................................... �l, Remarks: ='-•- '-_ _- L7tit,� <s-.. _...- -------------------------------------------------•---••-•--•-----"--..-......-••----------------------------•---•----•-•-- -------------------------------------------- ------------I----------------------------------------------------- ••••-----••••--•--------------------------------------'----------------------------------------------------- ------- -----'-------'------- ---------- -----------------------------•---------------------------------- Permit ------------------ Permit Fee Treas. Receipt $------------------------------------- No.--'---------.-...--.-....... By; -----------------------------------G /-i..a.: 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 work may be inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT No 16099 Address ......................"-.....................-................................................._..............-....................... Date........:::.................-.._......_................ Owner ................................................................_.......................................................... Tenant-------'...................................---...............--... WiringContractor..........................................................._............................................................. By.......................................................-...... 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 work may be inspected before concealment.