HomeMy WebLinkAbout217 E 10th St - Building Building Permit
217 E 1 0`" St
13 - 158
roe
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY&ECONOMIC DEVELOPMENT-BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . 13-00000158 Date 2/11/13
Application pin number 138856
Property Address . . . . . . 217 E 10TH ST
ASSESSOR PARCEL NUMBER:,. 06-30-00-0-2-9065-0000- REPORT SALES TAX
Application type description PLUMBING PERMIT
Subdivision Name On your State excise tax form
Property Use . . . . . . to the City of Port Angeles
Property Zoning . . . '. ' RS7 RESDNTL SINGLE FAMILY (Location Code 0502)
Application valuation . 840
------------------------
Application desc
WATER SERVICE HOUSE TO METER
Owner Contractor
------------------------ ------------------------
ROBB, TTE MILDRED L ANGELES PLUMBING INC
217 E 10TH ST PO BOX 1151
PORT ANGELES' WA 983627833 PORT ANGELES WA 98362
(360) 452-8525
Permit . . . . . . PLUMBING PERMIT
Additional desc . . WATER SERVICE
Permit Fee . . . . 57.00 Plan Check Fee .00
Issue Date . . . . 2/11/1.3 Valuation 0 _ ..
Expiration Date 8/10/13-
,.- -
Qty Unit Charge Per Extension
BASE FEE 50.00
1.00 7.0000 EA PL-WATER LINE 7.00
---------------
Fee summary Charged Paid Credited Due
'Permit Fee Total 57.00 57.00 o0 .00
Plan Check Total .00 .00 00 00
Grand Total 57.00 57.00 00 .00 '
Separate Permits are required for eiectricalwork,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes
null and void if work or construction authorized isnot commenced within 180 days,ifconstruction or,work is suspended or abandoned
for a period of-180 days after the'work:hai commenced,-or if requiredilnspections'have'n6t been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know1he 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. -
-/ /(�5'zLIJ
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
T:Forms/Building Division/Building Permit
BUILDING PERMIT INSPECTION RECORD Com;
PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS— { �,
Building Inspections 417-4815 Electrical Inspections 417-47354
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 FINAL Date Acc:e ted b
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 Pum /Furnace/FAU/Ducts
Rough-in
Gas Line
Wood Stove/Pellet/Chimney
Commercial Hood/Ducts FINAL Date Accepted b
MANUFACTURED HOMES:
Footing/Slab
Blocking&Hold Downs
Skirting
PLANNING DEPT. Separate Permit#s SEPA.
Parkin /Lighting ESA:
Landscaping ISHORELINE: c
FINAL`INSPEC,TIONS.REQUIRED PRIOR TO.00CUPANCYI'USE y'
lnspection Type Date Accepted By
Electrical 417-4735
Construction-R.W. PW /Engineering 417-4831
Fire 417-4653
Planning 417-4750 0
Building 417-4815 �\
a
T:Forms/Building Division/Building Permit
02/11/2013 09:26 3604528583 ANGELESPLUMBING PAGE 02/02
BUILDING PERMIT APPL
ICA TI011f Print in ink
J
! CITY OF PORT ANGELES FortCity use Only:
Attn: Building Permit Technician r
321 E. Fifth St_, Port Angeles,WA 98362 Date Received-'L
(360)417-4815 fax(3W 417-4711 Permit# /3-7
Date Approved /A,1
Applicant or Agent ANGELES PLUMBING, INC. _ _ Phone 452-8525
Property Owner MILDRED ROBB � � �� Phone 457-8700
Property Owner's Address 217 E 10th St. , Port Angeles
Contractor/Engineer ANGELES PLUMBING, INc Phone 452-8525
Contractor/Engineer's Address P.O. POR 1151, Port Angeles, WA 98362
License# ANGELPI077KP ExpiMS 5_15_13
PROJECT ADDRESS 217 E 10th St
Parcel Number lot Zoning
Protect Tyne&Brief Desg!W on XResA*n al a Commerchd 0 AWN-fame7y ❑Industrial
Check all that apply
u New Construction
o Addition
a Remodel
o Repair.
o Re-roof
❑ Demolition
❑ Heat System ❑Heat pump a wood-burning stove a gas fireplace o peWt stove u other
Other Replace water service
Floor Areas Exlslhfnb S a.fi'.J Pr0pa4sed/sa ill
Basement $ per sq.ft.=$
1 Floor
"d
2Floor _
3'd Floor
Garage
Carport
Covered Porch
Dock
Shed
Other
TOTAL VA,LUA-RoiV $ 840.00
Total footprint of structures sq.ft. `= Lot size SQ ft = Lot coverage %
Max. height of proposed structures ft. Occupancy group #of bedrooms
Will a lawn sprinkler system be installed? Occupant load #of full baths
Wif a fire sprinkler system be installed? Construction type #of half Maths
I have read and oornpleted this appffiGation eyed know it to be true and CW0Gt l am audwized to apply for this permit and
understand that it is my responsibility to determine what permits are required, and to obtain permits prior to working on
projects.
Date 2-11-11 Print Name DALE BRUNTZ Signalu
T:Forms/Building Division/Bldg Permit Appl.-2406 Code-doe
PREPARED 4/01/13, 11:35:30 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
------------------------------------------------------------------------------------------------------------------------------------
13 00000158 217 E 10TH ST 06-30-00-0-2-9065-0000- 063000029065
000 000 PL 00 PLUMBING PERMIT PL6 0001 PLUMBING WATER SUPPLY 2/11/13 APPROVED JLL
REQ COMM: February 11, 2013 12:25:00 PM pbarthol.
REQ COMM: DALE 452-8525
RES COMM: February 11, 2013 3:35:20 PM jlierly.
000 000 PL 00 PLUMBING PERMIT PL99 0001 PLUMBING FINAL 2/11/13 APPROVED JLL
REQ COMM: February 11, 2013 12:25:21 PM pbarthol.
REQ COMM: DALE 452-8525
RES COMM: February 11, 2013 3:35:27 PM jlierly.
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 08 00000669 Date 6/03/08
Application pin number 032666
Property Address 217 E 10TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 2 9065 0000
Tenant nbr name LEE ROBB
Application type description MECHANICAL APPL PERMIT
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 7550
Application desc
HEAT PUMP INSTALLATION
Owner Contractor
MILDRED L ROBB TTE PENINSULA HEAT
217 E 10TH ST 782 KITCHEN DICK RD
PORT ANGELES WA 983627833 SEQUIM WA 98382
(360) 681 3333
Permit MECHANICAL PERMIT
Additional desc HEAT PUMP INSTALLATION
Permit pin number 127753
Permit Fee 64 80 Plan Check Fee 00
Issue Date 6/03/08 valuation 7550
Expiration Date 11/30/08
Qty Unit Charge Per Extension
BASE FEE 50 00
1 00 14 8000 ECH ME INSTALL 100- FAU 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
15x i
E- 16-10
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 pro 'sions of an sta or local law regulating construction or the performance of
construction.
eoltl';X aw'114 A�-
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
T.Forms/Building DivisionBuilding Permit(10/01/07).wpd'
BUILDING PERMIT INSPECTION RECORD
0
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS 01)
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER,INSULATE OR CONCEAL ANY WORK BEFORE 6�
INSPECTED AND ACCEPTED POST PERMIT INA CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE -7DATE ACCEPTED COMMENTS
YES NO
FOUNDATION-
FOOTINGS
SHEAR WALLS/WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS
PIERS
POST HOLES(POLE BLDGS.)
PLUMBING
UNDERFLOOR/SLAB
ROUGH-IN
WATER LINE(METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY,
BACK FLOW/WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS/ GIRDERS
SHEAR WALLIHOLD DOWNS
WALLS/ROOF/CEILING
DRYWALL(INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL/FLOOR/CEILING
MECHANICAL
HEAT PUMP/FURNACE/DUCTS
GAS LINE 1 ^
V �
WOOD STOVE/PELLET/CHIMNEY FINAL DATE ACCEPTED BY.
COMMERCIAL HOOD/ DUCTS
MANUFACTURED HOMES
FOOTING/SLAB
BLOCKING&HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT U's SEPA.
PARKING/LIGHTING 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 /PW/ CONSTRUCTION R.W
ENGINEERING 417-4807 PW/ENGINEERING 7z)
Cz
FIRE 417-4653 FIRE DEPT
P.LANNING'DEPT417-4750. 11 . 4 PLANNING.DEPT
BUILDING 417-4815 BUILDING
T Forms/Budding Division/Building Permit(10/01/07).wpd
L��oV p/��fl BUILDING PERMIT APPL.I CA TI QN Print in ink
CITY OF PORT ANGELES
I For City Use Onl
Attn. Building Permit Technician Date Received
321 E. Fifth St, Port Angeles, WA 96362 Permit
(360)417-4815 tax(360)417-4711 Date Approved
Applicant or Agent Phone
Owner Z.Lo&— Phone
Owner's Address
Contractor/Engineer 1 Phone
Contractor/Engineer's Address
License# Q Expires _ /V
PROJECT ADDRESS OZ 7
Parcel Number Lot Zoning
Prosect Type &Brief Description. esidential o Commercial ❑ Multi-family ❑Industrial
Check all that apply
o New Construction
n Addition
o Remodel
o Repair
o Re-roof
❑ Demolition
0 sign o wall-mounted o projecting ❑freestanding ❑awning o other
Total stn area sq. ft Maximum allowed sign area sq. R
Wlqeal System sriqeat pump o wood-burning stove o gas fireplace o pellet stove ❑ other
o Other
Floor Areas Eklstlna(so. ft) Proposed(so. ft)
Basement @$ per sq. ft =$
1"Floor
2nd Floor
3'° Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION $ 7. 6s Z)
Total footprint of structures sq.ft. T Lot size sq. ft = Lot coverage %
Max. height of proposed structures fL 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 baths
I have read and completed this application and know it to be true and correct /am authorized to apply for this permit and
understand that it is my responsibility to determine wh t permits are required, a t btain per it or t working on
project . //''// 11Z,&
Date =4 3 Print NameC�K4 tl&W� GCSOW Signatur
T:Forms auilding 0ivisiorye1d9 Permit Appl.2006 Code.doc
zoo 1189g aTnsujuad 990ZT9909C YVa 6Z 90 BO/CO/90
Application Number 08 00000674 Date 6/04/08
Application pin number 401322
Property Address 217 E 10TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 2 9065 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
Replace to electric furnace
Owner Contractor
ROBB TTE MILDRED L PENINSULA HEAT
217 E 10TH ST 782 KITCHEN DICK RD
PORT ANGELES WA 983627833 SEQUIM WA 98382
(360) 681 3333 N 1
Permit ELECTRICAL ALTER RESIDENTIAL )\V\
Additional desc —�
Permit pin number 127803
Permit Fee 35 00 Plan Check Fee 00
Issue Date 6/04/08 Valuation 0
Expiration Date 12/01/08
Qty Unit Charge Per Extension
1 00 35 0000 EC EL LOW VOLTAGE 35 00
Fee summary Charged Paid Credited Due
Permit Fee Total 35 00 35 00 00 00 �—
Plan Check Total 00 00 00 00 r'�)
Grand Total 35 00 35 00 00 00 l\J%
INSPECTION ELECTRICAL
TYPE DATE RESULTS INSPECTOR.
BITCH
SERVICE
COUGH - IN
FINAL
COMMENTS :
Application Number 08 00000666 Date 6/04/08
Application pin number 897720
Property Address 217 E 10TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 2 9065 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Owner Contractor
ROBB LEE OLYMPIC ELECTRIC
217 E 10TH ST 4230 TUMWATER
PORT ANGELES WA 983627833 PORT ANGELES WA 98363
(360) 457 5303
Permit ELECTRICAL NEW RESIDENTIAL
Additional desc OLY EL / 200A SVC
Permit pin number 127720
Permit Fee 75 00 Plan Check Fee 00
Issue Date 6/04/08 Valuation 0
Expiration Date 12/01/08
Qty Unit Charge Per Extension
1 00 75 0000 ECH EL RM 0 200 1ST SRV FEEDER 75 00 `
Fee summary Charged Paid Credited Due , v
Permit Fee Total 75 00 75 00 00 00
Plan Check Total 00 00 00 00
Grand Total 75 00 75 00 00 00
V
INSPECTION ELECTRICAL
TYPE DATE RESULTS INSPECTOR
DITCH
SERVICE
ROUGH - IN
FINAL
l 2- YAP
COMMENTS.-
CITY OFPORT ANGELLIGHTLIGELECTRICAL PERMIT NY 15583
Port Angeles, Washington-----------/_-/-_-.f_6------------------------------ 1 ---5--
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 off/ --GJ'- // - ------'-. Occupancy
' - -
--•= ... --- r4Owner
------------ T
Wiring Contractor---- Tenant - - -
iSt .. . . ...... By--------------------------------------------------------------------
' U
Light Outlets..................................._..... Service. volts ..
..................................... Type of Wiring:
Receptacle Outlets............................... No, wires ----------.../�...._ Armored Cable ........................
Dryer,KW-------"-................. Size wires..!./G' Non-Metallic ............-..................
Knob & Tube.....................-..........
Range, KW.---'-"----....---'--------------- Main fuse .._..��........-........
Rigid Conduit ......................
Water Heater: Enclosure ....................................... Metallic Tubing ..................... _.
KW...................../. .....p............._.. Type of wiring: Raceway ......_......................
Heat: KW....._/.�.....�.1�Z................. Entrance Cable.......----------......... Circuits, Light---'-"----...........................
Motors: size, volts and phase: Rigid Conduit ............................... Utility ..................-..........................
MetallicTubing ........................... Heat ....-.-..........._------_.-_-.........
..........................................................
Current transformers: Range .............................................
..._...-------------------..........................
No. & Size....................................... Water Heater ...............................
...........................................................
.-. .
Ser. No................... Motor ....---.....................................-
............................__........._....._..... .
......... Dryer................................................_
.A Ser. No..............'.---...............-..
........................................................_
Furnace........................_..................
NoSer. No..............................................
TotalLoad----------------------------- Ser. No.................._.......................... Total .......................................
Remarks: -----------!ac y-- -------------------------------------------------•--------
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
-------------------------------------- ----------------- -----------_--- ----------------•----------------------------------------••---••-----
Permit Fee Treas. Receipt i � /) ���k%2�a�Ka'..
$------------------------------....... No............................. Bye.- --�------ - -
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 N° 15583
?l� tC
Address .... Date.....................................................
Owner .....--- -----------.....:..-r'... _�'�.P��j->�....�................................................ Tenant.----......------..---.........................................
Wiring Contractor---.. . ........-------. ....... . ...."?^uI/..Y..':.`.......^..�-:'................................... By.......................-..-......------------.----------......
NOTICE—Current must n 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. -
... moi......,.,. Lm'.o_ tne.
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST:
Date 12 -�--U -? Time C7:12V /Received by / (phone erso
&2TLNLocation of Work to be inspected 6/7 C -&21--1-
Name
ame of person requesting inspection z, alel- 12i✓.
Address of person requesting inspection 703 .C¢- �FS�ST Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excay. ther P/
INSPECTION NOTES:
Inspected: Date Time ;/� By 7/-7
marks: tt
RESTORATION REQUIRED . . . . . . YES NO—
/0 7-k
O/07-k
a
r
SURFACE RESTORATION:
SURFACE TYPE: ❑ Unimproved' ❑Gravel ❑Asphalt ❑PCC Other r -
❑ Repaired by City Work Order #
❑Repaired by Permittee ❑ COMPLETE
❑No Damage Found INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
ELECTRICAL WORK PERMITAPPLICATION
Installation description
Job wired by eclrical Contractor ❑Owner ❑ Commercial widentlal
Ele 'cel contractor name Li se umber D Expitrs \7
en�ns d, /n//Q AN
❑New 0 Altered/Addition rV\7�l
Rhasera i,ieg add ra
Ci Stale tP
phon nu er FAX number _L
/- DS
Pre ret e.ner' e bib 1'e oi,/
Address of Inspection
2 C - le, /r/sem'//
Qtr A4n�
Phone heoi& insorlon
ff
Owner as defined by RCW.19.26.261r(1 Owner Q11 occupy rhe srrucwry far two RECEIVED
years after this electrical permit is finalized (2)Owner is required to hire an elecMcal
contractor if above said property is for dale, rent or leafe. Cl Cash ❑ Check,dUN O 4 21IN
After reading the above statcmen,I hereby certify that I am the owner of the above
aeed property or a licensed, contractor. I am making the electrical instal- ❑Credit Card Mastercard Discover
m
lation or alteration in compliance with the electrical laws, N.B.C., RCW. Chapter ,-
19.211, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and Card All ____ _
Utility eificationa.
51 dq
a %of owns ale I c tree r ar ale tried administrate Expiration Date
of card
ate: 6 ; $
EIeo1Hc1U Load Additions and or subtractions Service Information
O NO LOAD CHANGES
❑ Baseboard _KW Voltage
O Furnace —KW O Overhead Service Phase❑ t O 3
Pump Ton LAR ❑ Temp Servlce Service Size:
❑ Fan-Well —KW O Underground Service Feeder Size:
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-4174735
ROUGH-IN THERMO7-AOPM�
SMVICE
n... Al.nr d 61 D.I. .a er D.I. AwmN ed By
FINAL DITCFEEDER
n... Aw�ro. SyC o.m BY
ED.,. Aoora•.a By
Inspection Ama,Buildingor Equipment Inspected Action Taken Electrical
Date - Inspector
Cola 1E9g eTnevTaad 990ZT9909C YVI 69:90 90/CO/90
06/02/2008
/02/2008 09: 14 FAX 360 452 3498 Olympic Electric Co. Q 001/001
v
I t
ELECTWCAL WORK PERMITAPPLICATION
loolallation description �l
Job wired by UrfleetrIcal Contractor O Owner D,Commercial aldeatlal
mccurical commoscr n.ma ALilconlre number bier Enpi�ead O Now C AlteredlAddltloo
' Q� ir 9
ailing
address
Ch Sale ZIP
r✓7,
Telephone number FAX number
Premlia owner' name
RECRIVED
Address of Inspection —
7/ 7 F &—r—'
Phone number to ocbedule loopeetloot U�y
LIGHT DEPT.
Owner as defined by RCM/9.26.261:fp Owner will occupy the strvcturc for two
years after this elsclrlml pemdl Lr flnolLed.(7)Owner it required to hire on electrical
contractor if about safd prepwry Is far rale, rent or loan ❑Cpdh U Check p
After reading the above satanent,1 hereby sonify that I am the owns or the above
aamod property or a licensed eleostlaal contraolm. I am making the electrical Instal- l <'mdlt Card Ylsu Mastercard Discover
Islion or alteration In oompliaaee with the electrical Iswt,N.E.C.. RCW, Chapter
19,28, WAC. Chapter 2966468, The City or Port Angeles Municipal Code, and Card a _ ___--—.--_
Utility Specifications.
Slgoswre of owosr, electrical contractor or electrical adminlslrolor ExpRBtionDate
napes on ee=
x Date: � p of card S
Ions a_nd or aubtrectlona Service Information
C1 NO LOAD CHANGES y
O Baseboard KWvoltage
O Fumeoe tt KW t1 Overhead Service Phase U'1 0 3
0 How Pump 7- Ton,LAR 0 Temp Salvino Service 91re:,�
D Pan•Wel:' —KW D Underground Service Feeder She:
SAME DAY INSPECTION CALL BEFORE 7:00 AM 360417-4735
ROUC U`^N ^ THEBMOSTAT clll�- CFIIVI(E
-12 AOPW14 by_ Ata '
AL DUCH FEEDER
. Ar nm A— ,rem e—a,-
Ts'
'fie r
Idle
Inspection Arta,Building or Equipmentlmpected Action Taken Electrical
Dole , . Inspector
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