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FEe AECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
710
PERMIT NUMBER
.
TOTAL FEE
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CONT. Lie. NO. TIME TO COMPLETE
NO. ST<~RIES
LEGAL OCCUPANCY
Site Address
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
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ADDRESS IS RESPONSIBILITY OF APPLICANT PERMITS WIT~ WRONG ":D~ES ARE CANC>I-lI-D J
Owner Installation By //~.-./ i L ~n I c...
Owner's Address . ~ .. Installers Address ::---
Day Phone"'-- Installers Phone .____
Application is hereby made for Permit to install Electrical Equipment as follows:
JJtw ADf)rTl1) fl./' 7D fJ/c L{/IL~ ~#rc:~.
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./OJ'l. W1vlr' ~,v A-Vr S,l?AC. ,t. lJur &~ If'11JN&,.tK;(Method /t"
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NUMBER AMP 120V 240V sN~ S/ ~EA AMP 120V 240V
USE OF CIRCUIT CIRCUITS PEA 10 leOR FEE o US OF CIRCUIT CIRCUITS PEA 10 100R FEE
CIA 30 CIA 30
LIGHT SIGN
. 50 VOLTS .
LIGHT OR LESS
CONVENIENCE -- MOTOR
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CONVENIENCE VB t w. ~l5. L IJA'7 / I CYO' J ~ IT!.. ~121L. 1/,7[ s:
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APPLIANCE Lt6 il'T.5" ~ a ~ A/. ~ MOTI A f~ ( -, I" / I,
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DISHWASHEfI t2.oc A-,..,. i? At, ",'t L I.t ~~~ c. If; r- J4'V I v-' r / '-' rill It--
DISPOSAL '1'fi " A j/ #f L rc~YI!!!..""Ai1"t.t, IT j .. ./. /) .1..1 on....
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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
A.C. UNIT AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE AW.G.
I SUB-TOT At. SIZE OF GROUND SIZE OF ENTRANCE SWITCH
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I certify that the work to be performed under this permit Will be done by the installer an~ma,nce with the N.E.C. Electrical Code
Date Application made rjlc/rt ,19 By .c.., W~
I CONTRACTOR OR OWNER (OR AUTHORIZED AGENT)
Permission is hereby given to do the above described wo~k, according.to the conditions hereon and according to the approved plans and'
specifications pertaini'ng thereto, subject to compliance with the Ordinances of the Ci.ty of Port Angeles. -. '. :.:...... .;,.:;.;j;~'.'
DIREC O'R ,F. 'ITV liGHT",} t." .: .
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Notify Department 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. .
.
Date Permit Issued
WARNING
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
_OL Y"'iptC PRINTERS, ~9:.
REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
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, III\.~ O.K. FOR COVERING
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V FINAL O.K. iJO ~ hL- F/~ 1/7-1/11 ~
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16593
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Port Angeles, Washlngton..n.___..o___.___________::_________________________________. 19,::0000,
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.
5(").2 ~ ~ A....~
Address ._______n."'______________________._________nnn________n__________.n.___n______..n Occupancy.--.,.-----------___-----------..-----_..----n
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Owner ---~-.~~-.,.-~~~--------n---nn-..-----~""""'c:2?a~,~w-----------n------nn-------____0000_____________00_____________
Wiring Contractor ___t?'.J:~.~~n~~nn__.n___:~;~y..--.-.-.------------nn.--------------------------.-------.--------
Light Outlets........___._......................__... Service, volts ../~'?_!:.i!.J!I!..ii!... Type 01 Wiring:
Receptacle Outlets__m.__....................... No. wires .....:.?..~_____..._.__#Oo_.._______ Armored Cable .......-......................
)P4tPf/
Size wires.z...n..__....._.............._..
Main luse ..~~.6:~.............
Enclosure ....':'=__.....m_..mnmm___mm
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
Dryer, KW nn......h......................_.__....
Range, KW __________.n._n______u_.____n______n.
Water Heater:
KW.__....................__....n................
He." Kw......Jj.L..f!..B.......
Type of wiring:
Entrance Cable __......._.....__......_.....
Motors: size, volts and phase:
Rigid Conduit .......................___.....
Metallic Tubing ...........................
Current transformers:
No. & Size.......................................
SeT. No...............................................
SeT. NO.........d...................................
Ser. No.__.....................__..........____......
Nt.'
Non.Metallic .................................
Knob & Tube................................_
RIgid Conduit .h..........................._
Metallic TUbing ...........___d...........
Raceway ............__.................__..._
Circuits. Light.........................__........_..
Utlllty ........h.....C......_....................
I-Ieat ......................................._.._
Range .............................................
Water Heater ................___..___....__.
Motor ..._......................................._
Dryer ....................._.......................__
Furnace .........................'_......_...........
Rem~;k:~ta:..~~~__.~__.~__.___~.::-:~~~~.:~:<:~~-:~.~:.:~~..._~:~::__~::~:::.__:~::_._:::~::~__~::~::
-;~.=.;-~--~:~----~----..-..~_~~~~_-..---......::~_~_~:__~~_~_~:_~_~~..._~~~~~...-----...-......::<Li~~~i::~~~<
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NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be COD.
cealed due noUce 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 "
Address
...--.............._...................................~-;;;.............................................................................
Owner ..................................._......_.._......_......_.._........................................................... Tenant..................................d..................._..........
-
) , N?._o. 16593
Date..._~....._.._.._.._......._._.._.._......_......._
'..
WirlngContractor..................................._.....................................................................................:8y..............................................................
. NOTICE-Current must not be turned on untll Certificate of Inspection has been issued. If work Is to be con.
'\ cealed due notice must he given the Inspector so that work may he Inspected helore conceal,ment. .
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