HomeMy WebLinkAbout235 W Forest Ave - Building
10 Cf3
FEE RECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
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PERMIT NUMBER
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TOTAL FEE
30
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CONT. LIe. NO.
TIMETQ COMPLETE
NO. STORIES
LEGAL OCCUPANCY
2. ~> fOrzUT A-U.
CORRECT ADDAESS IS RESPONSIBILITY OF APPLICANT
DICK.: D~loh.,J
Owner's Address . .~ 3 r . Fe> tt,E xr
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Site Address
A-v.
PERMITS WITH WRONG ADDRES~ES ARE CANCEl~
Installation By t?m h.l f'( F C- L-
Installers Address
Owner ~
Day PhO:16 Installers Phone
Appllcat.on IS hereby made for Permit to install Electrical Equipment as follows:
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Wiring Method
.
NUMBER AMP 120V 24QV NUMBER AMP 120V 240V
USE OF CIRCUIT PER 100R FEE USE OF CIRCUIT PER 10QR FEE
CIRCUITS CIR 10 30 CIRCUITS CIR 10 30
LIGHT SIGN
LIGHT h 50 VOL IS
OR LESS
CONveNIENCE .- MOTOR
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 50-
TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
A.C. UNIT AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE A.W.G.
I 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.
5/;2..-/ 'Ff, ,19 By )d(J~b
I / . I CONTRACTOR OR OWNER (OR AUTHORIZED AGENT)
Permission is her~by given to do the above described work, according 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. . ,
DIRECT R F CITY LIGHT
Date Application made
Date Permit Issued
.
I WARNING
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PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
WHITE. Original CANAAY. Duplicate PINK. Triplicate WHITE CAAD. Inspector's Report
OLYMPIC PRINTERS, INC.
REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
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O.K. TO CONNECT,SERVICE
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