HomeMy WebLinkAbout2025 W 16th St - Building
/2- 3~
FEE RECEIPT NUMBER
CITY OF PORT ANGELES .
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
f}z0
PERMIT NUMBER
.
TOTAL FEE .-- lfo~ ---- --- ~- 1Z'lr r.
CONT. Lie. NO. TIME TO COMPLETE NO. STORIES LEGAL OCCUPANCY
-
Site Address
ELECTRICAL PERMIT ONLY
JA./ -j & 7J\
ODRESS ISrRESPONSIBILlTY OF APPLICANT
o tI A-'L.
NO OCCUPANCY OA USE ESTABLISHED UNDER THIS PERMIT
Owne.r
Owner's Address
Day Phone
Application is h~reby made for Permit to inst.all EJe
Installation By
Installers AdCJress
PEAMITS WITH WRONG ADDRESSES ARE CANCELLED
E(Fcc/CtL
,IF .ICe/I (' L
Installers Phone
~,
Wiring Method
.
NUMBER AMP 120V 240V NUMBER AMP 120V 240V
U$EOF CIRCUIT PEA "100R FEE USE OF CIRCUIT' PEA 100R FEE
CIRCUITS CIA 10 30 CIRCUITS CIA 10 30
LIGHT SIGN
LIGHT 50 VOLTS
OR LESS
CONVENIENCE - MOTOA
CONVENIENCE - MOTOR .. .
APPLIANCE .. MOTOR - .
DISHWASHER FIRE ALARMS
DISPOSAL BURGLAR ALARM
-
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 CONDU~TORS
SERVICE AW.G.
T SUB-TOTAL -
SIZE OF GROUND SIZE OF ENTRANCE SWITCH
I certify that the work to be performed under this permit will be done by the installer and in conformance with the N.E.C. Electrical Code.
Date Application made / III f-I:, 19 By X A~
/ ~ I ';/ ~ONTRACTOR OR OWNER (OR AUTHORIZED AGENT)
Permission is hereby given t.o do the above described work, a.ccording to the conditions hereon and according to the approved plans.and
specifications pertaining thereto, subject to compliance with the Ordinances of the-City of Port Angeles. '
- < DIRE OR 0 CI Y IGHT
WARNING
~'-/16 BY' ""., . '\
I 1/ v PLANS APP VED' _ ,-
Notify epartment 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 s~rvice has been given by Inspector in
'Writing on Permit Placard. A.. Permits Phone: 457.0411 Ext. 158.
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER -
.
Date Permit Issued
WHITE. Original CANARY. Duplicate PINK. TrIplicate WHITE CARD. Inspector's Report
OLYMPIC PRINTERS, INC.
REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
. ~. rQr;1::s! 8 _..lffu
Iff r 'err '(t- O.K. TO CONNECT SERVICE
~ \
...Mnlol.rn~
.
z
Cl
a:
ct
::0
~
:r
I-
Z
W
I-
~.
I-
o
Z
o
Q
.