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FEE RECEIPT NUMBER
'CI1:V OF PORT ANGELES '.
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
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PERMIT NUMBER
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. TOTAL FEE
SO, (7)
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CONT. Lie. NO.
TIME TO COMPLETE
NO. STORIES
LEGAL OCCUPANCY
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Site Address vol>
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PONSIBILlTY OF APPLICANT PERMITS WITH WRONG ADDRESSES ARE CANCELLED
.. . Installation By ~a4 ~ '?vs:.r~I~-
1'OlC\ ~N~Uli~stallersAddress-pA:l h..., blo :!E>~c.eWfl\ ~3-B
DaYPhone~:52~ j;},;;). .. InstallersPhonegzg.'2ilb9 . ~
Application is hereby made for.Permitto in.sJall ElectrJcal EquJpment as foJlows: 200 ~ P ,-<) ERIJ IC€..
~ \ rct r)l~..u.J r <S \ d tf\('~ .
Wiring Method .N.m ~ 5
.
AMP ~F AMP " 240V
~ . USE OF CIRCUIT NUMBER 120V USE OF CIRCUIT NUMBER PER - 120v 100A FEE
CIRCUITS PER 10 10 R FEE CIRCUITS 1'0
CIR CIR 30
LIGHT Fl I~ v' SIGN
- 50 VOLTS -
LIGHT, OR LESS
- .. . - - .~-
CONVENIENCE MOTOA
CONVENIENCE .. - MOTOR I. -
APPLIANCE K ~.,. ~ ~ .;to- ../ . . MOTOR -
DI~HWASHER I :::>l'I -V .. FI RE ALARMS
DISPOSAL BURGLAR ALARM
, ,
RANGE I 60 V MISC.
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OVEN r. .n" ">;>'/ , ~\" ../
WATER HEATER I ,~a V
( ~O ../ .. ..
LAUNDRY
DRYER: ' . REINSTALLATION LIGHT FIXTURE # . . .
FURNACE . . SUB TOTAL FEE .-
GAS - OIL
FURNACE ENERGY FEE
ELECTRIC ..
a J BASIC FEE
ELECTRIC HEAT ~o .-C- -
TOTAL FEE
ELECTRIC HEAT J ~o ./ SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
.. ..
AC. urillT ~~o AMP -L.~ PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUC;rORS
SERVIGE ) 001 4lb 4-1~Z/o AL A.W.G.
SUB-TOTAL .n SIZ~ OF GROUND l,/l 't ~1zE OF ENTRANC;SW;TC~.::l O()
. .
I certify that the work to be. performed U~dert~is ~ermit Will. be done by the installer and in conformance~th the N.E.,C lectrical Code.
DateApplicationmade f)e.C{>VY)tjir \l.o .198'':;- By u..
.~ NTRACTOR OR OWNER (OR AUT-HORIZED AGENT)
Permis~ion is hereby given to do the aboye describ,ed work, according to the conditions Iiereon and according to the approved Rlans and
specifications pertaining thereto, subject to compliance with the Ordinances of the City of P,ort Angeles. : ,..1. ~~' ( (
... - -. . . - DIRECTOR OF Y LIGHT. -/<./)/t;-"
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. Da~e. Permit .Issue.d
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I WARNING
ROVED
Notify Department of City Light by Street d ss and Permit Number when ready for inspection. Work must not
be, covered of.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.
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER -
WHITE - Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
nl Vt.JIPIr.:p!::m,ITFR!':. 11\lr.
REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
y.L. IO( '1if-M ^ O.K. FOR COVERING
\ '"\ \,.., " 19.( 'YJ. ~ O.K. TO CONNECT SERVICE
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FINAL O.K.
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