HomeMy WebLinkAbout622 S Lincoln St - BuildingApplication Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
3 circuits add fans to radiators
Owner
PORT ANGELES MASONIC TEMPLE
PO BOX 1076
PORT ANGELES
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty
1 00
2 00
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
CA"r 314h)
INSPECTION TYPE
Unit Charge Per
73 5000 ECH
2 6000 ECH
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 983620203
163154
78 70
4/01/10
9/28/10
Charged
78 70
00
78 70
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
10 00000312
227640
622 S LINCOLN ST
06 30 00 0 1 6690 0000
ELECTRICAL ONLY
COMMUNITY SHOPPING DISTR
0
Contractor
OWNER
ELECTRICAL ALTER COMMERCIAL
Plan Check Fee
Valuation
EL BRANCH CIRCUIT WO /FEEDER
EL ECH ADDNT BRANCH CIRCUIT
Paid Credited
78 70
00
78 70
DATE
00
00
00
Date 4/01/10
00
0
Extension
73 50
5 20
Due
RESULTS
00
00
0.0
Signature of owner or Electrical Contractor X Date
INSPECTOR.
CITY OF PORT ANGELES PERMIT APPLICATION APR 2009
Building Division/Electrical Inspections ELECTRICAL
321 East Fifth Street P 0 Box 1150 Port Angeles Washington, 98362 INSPECTIONS
Ph (360) 417 -4735 Fax. (360) 417 -4711
Date.
1 2 Single Family Dwelling
Plan Review May Be Required Please Complete Electrical Plan Review Information Sheet
Job Address: S rc.ot S-I:- (r(1 a_5011 Te.xytpIP.)
Building Square Footage: o
Description of above )4L4 CC t6. i)4 E ADL AT11 3
>,-4.:.:./> e- C:?: /t.>2, ..,1 97 Jule A,1-7 O 7 z E,7I4 fv
Owner I formation Co ntra c tor Infdfmation
us�
Name: 7�-t,/ 42/71 /2 G Name:
Mailini- ,M8 f� /I. %40 '/6 7 Mailing Address:
City' Air ./i State://0,6 Zip: %'3 t v City State:
Phone:_ S 9 yy454x: Phone: Fax:
License Exp. License Exp.
Item
Service /Feeder 200 Amp.
Seryice /Feeder 201 -400 Amp.
Service /Feeder 401 -600 Amp
Service /Feeder 601 1000 Amp.
Service /Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp.
Temp. Service /Feeder 201 -400 Amp.
Temp. Service /Feeder 401 -600 Amp.
Temp. Service /Feeder 601 1000 Amp
Portal to Portal Hourly
Sign /Outline Lighting
Signal Circuit/ Limited Energy First 1500 sf Commercial
Note: $5.00 for each additional 1500 sf
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
Thermostat
NEW CONSTRUCTION ONLY.
First 1300 Square Ft.
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Multi- Family or Commercial* Commercial Addition Alteration Remodel Repair*
Unit Charge
119.90
145.50
204.60
262.20
372.50
2.60
73.50
2.60
92.70
110.30
148.70
167.90
95.90
88.20
95.90
63.90
63.90
119.90
102.30
56.00
110.30
35.20
73.50
110.30
Qty
R EC E,l @!'bbl
c_Le G t) 11-
Zip:
Total (Cif Multiplied by Unit Charge)
7? -Total
Owner as defined by RCW 19.28.261 (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required
to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor I am making
the electrical installation or alteration in compliance with the electrical laws, N E.0 RCW Chapter 19.28, WAC Chapter 296 -46B, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14 05 050 regarding Electrical Permit Applications.
Signature of owner electrical contractor or electrical administrator Cash Check
Credit Card
X 641,1-1 L 7 4 ,gi� Dated: 1 /0 0110112010
0
V1
pORi,w
(fr
Application Number
Property Address
ASSESSOR PARCEL NUMBER
Application description
Subdivision Name
Property Use
Property Zoning
Application valuation
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
T\PLANNING\FORMS \1102.15 [11/14/2003]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
RIGHT OF WAY
03 00001226
622 S LINCOLN ST
06 30- 00 -0 -1 -6690 0000
RIGHT OF WAY
COMMUNITY SHOPPING DISTR
0
Date 1/28/04
Owner Contractor
PORT ANGELES MASONIC TEMPLE DOWN TO EARTH LANDSCAPING
PO BOX 1076 306 S VALLEY
PORT ANGELES WA 983620203 PORT ANGELES WA 98362
(360) 452 -0824
45 00 Plan Check Fee 00
1/26/04 Valuation 0
7/24/04
Qty Unit Charge Per
1 00 45 0000 ECH RIGHT OF WAY PERMIT
Fee summary Charged Paid Credited Due
Permit Fee Total 45 00 45 00 00 00
Plan Check Total 00 00 00 00
Grand Total 45 00 45 00 00 00
Extension
45 00
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 as 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 provisions of any state or local law regulating construction or the performance of
construction
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
FOUNDATION
FOOTINGS
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT
ROUGH -IN
PLUMBING
UNDERFLOOR /SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE PELLET CHIMNEY
HOOD DUCTS
PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT SEPARATE PERMIT #'s SEPA.
PARKING/LIGHTING I ESA.
LANDSCAPING I I I SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES I NO
ELECTRICAL LIGHT DEPT
CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS.
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
FIRE 417 -4653 I
PLANNING DEPT 417 -4750 I
BUILDING 417 -4815
f *PLANNING \FORMS \1102.15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
YES I NO
417 -4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW ENGINEERING
I FIRE DEPT
I PLANNING DEPT
BUILDING
.
Site Address:
<-
Installed By:
Owner/Business:
Owner/Business Address:
C Residential
Heat KW
o Baseboard 0 Furnace/Boiler
o Heatpump 0 Other
o Commercial/Industrial load
Total Connected load
(attach breakdown)
Total Motor load
(attach breakdown)
Detai I slDescri ptlon:
CITY OF PORT ANGELES
LIGHT DEPARTMENT
PERMIT NO. c5? / -.5- c.;
DATE !f ~/3,/?9
ELECTRICAL PERMIT
s.
o READY FOR 0 WILL CALL FOR
INSPECTION INSPECTION
License Number: Phone:
C ,",CQ I ".J
Phone:
Sq. Ft.
o New Construction
o Remodel
o Service update/alter/repair
o Overhead
o Underground
Voltage
010' 030
Service size
o Temporary
o Add/alter circuits
o Auxiliary power
(list below)
o Special equipment
(list below)
Amps
/:. t, e~ led
Ald d L-d
.
~J .fs J
..$ Ceo 1-5.
,
~-h..-.<:-.
W.S. No. Service
Capacity: 0 O.K. 0 Not O.K.
o Di.tch inspection O.K.
-1~ Rough.in/cover O.K.
o O. K. to connect service
N. 'iI'1 Final O.K.
1r:tCM"\:
Site Address:
Installer:
Size
Comments
Date
Hoid for: 0 Easement 0 Letter
o Signed up for service/meter
o Meter Department notified for installation
o Fire Department notified of inspection
o Plan Review approved/pending
L,-",c~/..J
E/4-.
permit:;;tj S- 'f
New Meters
...t)-
Notify the Depart nt 01 City Light by Street Address and Permit Number when ready lor inspection. Work
must not be covered or electrically energized before inspection and O.K. for covering or service has been given
by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT.158 or EXT. 224.
~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT / (; ~
Inspector Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
.
OLY'" "Ie PFlINTERS. INC.
Installed By:
CITY OF PORT ANGELES
LIGHT DEPARTMENT
PERMIT NO.
1939
//.//s/j' .i'
ELECTRICAL PERMIT
DATE
.
Site Address:
o READY FOR
INSPECTION
License Number:
o WI LL CALL FOR
INSPECTION
Phone:
Owner/Business:
Phone:
Owner/Business Address:
Sq. Ft.
o Residential
Heat KW
o Baseboard 0 Furnace/Boiler
o Heatpump 0 Other
o Commercial/Industrial load
Total Connected load
(attach breakdown)
Total Motor ioad
(attach breakdown)
o New Construction
o Remodel
o Service update/alter/repair
o Overhead
o Underground
Voltage
01.0 03.0
Service size
o Temporary
o Add/alter circuits
o Auxiliary power
(list below)
~ Special equipment
(list below)
Amps
DetailslDescription:
~IUS -h.-Il
SI~rJ
I
F
(
( I
l) I/Lf
.
W.S. No. Service
Capacity: 0 O.K. 0 Not O.K.
o Ditch inspection O.K.
o Rough-in/cover O.K.
o O.K. to connect service
,
'0 Final O.K.
--1/fM--
Size
Comments
Date
Hold for: 0 Easement 0 Letter
o Signed up for service/meter
o Meter Department notified for installation
o Fire Department notified of inspection
o Plan Review approved/pending
Installer:
Permit/Receipt No.
Site Address:
~,
/93
.
t-
Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work
must not be covered or electrically energized before inspection and O.K. for covering or service has been given
by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT.158 or EXT. 224.
~ ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT .;:) 6 ,'!;f1
Inspector Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
KA
New Meters
()
OLY~PIC PRINTERS. INC.
'" R?cE~ ~BER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
~ ttJ
PERMIT NUMBER
,. ,
.
TOTAL FEE . ,21 r:!?- . AM/'1 ',.
CONT. Lie. NO. TIMETO COMPLETE NO. STORIES LEGAL OCCUPANCY
-.
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Site Address
~SDAJ( C-
CORRECT ADDRESS I RESPONSIBILITY OF APPLICANT
PERMITS WITH WRONG ADDRESSES ARE CANCELLED
Installation By p.tJ GH.f. r r.(icTI2.-' L-
Installers Address
Owner
Owner's A'ddress
Day Phone Installers Phone
Application is hereby made for PenTlit to install Electrical Equipment as follows:
!Vfw f~uf",,~^'t ~ M:T1.JLt..o CUL' \
Jt>f..
Wiring Method t./VLv-. r
.
NUMBER AMP 120V 240V NUMBER AMP 120V 240V
USE OF CIRCUIT CIRCUITS PER 10 100A FEE USE OF CIRCUIT CIRCUITS PER 10 100R FEE
CIR 30 CIR 30
LIGHT SIGN
50 VOL is .
LIGHT , OR LESS
.. It -+ <J I b!E- ,. .
CONVENIENCE '- - MOTOR
CONVeNIENCE 7- '1;.. . {j9'" MOTOR
APPLIANCE 1.4~ MOTOR. .-
DISHWASHER I FIRE ALARMS .
.
'DISPOSAL BURGLAR ALARM
RANGE I MISC.
OVEN )
;WATER HEATER ,.,
LAUNDRY rtJ /'
DRYER J1 ./ REINSTALLATION LIGHT FIXTURE #
FURNACE f\/J< SUB TOTAL FEE
GAS. OIL
FURNACE f/ ./ 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 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.
Date Application made
,19
By
CONTRACTOR OR OWNER (OR AUTHORIZED AGENT)'
Permission is hereby given to do ~he 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. ' , ". ~;'",'. ~
. DIRECTOR OF CITY.L1GHT ',. . < ~\
WARNING
By
PLANS APPROVED
Notify Department of City light by Street Address and Permit Number when ready for inspection. Work must not
be covered or c.urrent 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 SE KEPT POSTED ON THE WORK - SEE OVER -
Date Permit Issued
.
WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
OLYMPIC PRINTERS, INC.
r
CITY OF PORT ANGELES
LIGHT DEPARTMENT
N~
17505
ELECTRICAL PERMIT
Port Angeles, wasb1ngton..___.:l....~.......___.______..___.___....__.______, 19.1l:
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-
=.~';;:~~:,,-=:~~::::==
Wiring Contractor __.~~___.~~.--..-- By.......____________._____.___.___......___.n......._____.n......__..
LI:Jht Outl.ts..............................._.._..... s.rv:co..' wvolrl.tss :~.....r;...;...~~~.~.........: TYP::::::~hl. ...mmm....m...''''''
Receptacle Outlets.........____............__.... ~7?"-'
'f6 .
Drier, KW nnu....__.__.........._______.__.._n__ Size wlres.;.~.J._.,;:....-..-----.......-.. Non-Metallic ..........._..__............__h.
.,' -,;/'" Knob & Tube___...n......_d.....n........~
Runge, KW.___....____.__n______u______._____ Main fuse -.':...m..............m......
Wa.ter Heater:
KW.mm..m.m....__m.....mm..mn...
Heat: KW..............._.................nn...n.__n
Motors.;,. Bl~o1tB and Vj,se:
~~.~..
&'Jil!i:::::~:~~~:.~::~
c..m.m...--...................m........--..........
Total wad__....___....................
RIgid Conduit ..........h...................
Enclosure ...._mmm...m_h.__...........__
Metallic Tubing ...........................
Type of wirIng:
Entrance Cable .......................
Raceway ........................................-
CIrcuits, LIght.......................................
DllIlly ..........m...............m..............
RIgid Conduit ...............................
Metallic Tubing ......
Heat .......................................-......
Current transformers:
No. & Size.......................................
Range .............................................
Water Heater ...............................
Motor ..._........................................
Ser. No..............................................
Ser. No..............................................
Dryer ................................................-
Furnace ..........._............'_......_...........
Ser. No..............................................
Remarks: m.......________..___m...nm____.___.........nn..___.nnn__..________.....m..______.m___m...____._____________...______________n__.________
Ser. No..............................................
Total ............b.........................
-......---.-..-.--..-.---.---.--.-.....-----.-.--.-.-....-.........---.--..---..---.-.-.---..-..-.--.---..-.-.....-----------..-...-........---.--.--------..--.-----.-.----.--.
.:~.=.~~...~:~~~.~._.___.____._~......--------::~.~::_.~.~.~~~~~~~~_.~.m..n...h--..:~.~~2~d~~
NOTICE-Current must not be turned on until CertifIcate of Inspection has been Issued. It work is to be con.
C3aled 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
N~ 1 7 50 5
ELECTRICAL PERMIT
h.ddress..................._.....................-.....................................................................__.........._...........Date..._......_.._.._.._._........-......-......-.........
Owner ......h..........................._......_.._......_......_.._............................-.............................. Tenant....................................................................
,,--
1': ~Iring ~S?ntractor...........................................................-............................................................. By ........................................--....................
f (( NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work Is to be con.
. t. ) C&d.~dUe noUce must be given the Inspector so that work may be inspected before concealment. .
<
'~
1M Olympic Printers, Inc.
r:-fJ) 10
port Angeles, Washlngton__..__m_____,_m________m_____..___m__mm_____m, 19000__000
In a~ordance with the City Ordinance to regulate the installation, extension, or repair of elec-
trical equipment In, on, or about any jlUildlng or other structure In the City of Port Angeles, per-
mission Is hereby gra~ted to~ elec.trlcal work as listed below.
Address -----J:~-y--()G.~~~:.---a.::;m-------- OCCUpanCy.__~----------m--m--.--
Owner m__,__~a:.?"'.!f;2-z.d~m--------m~9[~.lI'enantm---m--..----.m------------m-------_mm....m_______..._____
Wiring Contra~tor ______&__~-----E0S-<,e.~C;:.c- By_________m__m__m_mm_m;7'________.____,__m_____________
'./$/ Light Outlets____....._____..._____.________..__.._.. Service, volts.. ..../P.y.J...y:v
Receptacle Outlets..........____................. No. wires -.....~........~i.i-.._..
D,ye<, KW -..--....------------------....-------- ~l~n :~::s_:::::::~:~:-;::Ar...:....~::
Range. KW....____m_.....___mh...__ MJ:h..... i.7 r;,r ,.
Water Heater: Enclosure .m...euT~fm.......--
KW.....___um.........________..... Type of wiring:
Entrance Cable __....m_____....._. .......--~ '"
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
Heat: K W..............................n............--~....
Motors: size, volts and phase:
Rigid Conduit ___........._m_....___.......
Metall1c Tubing ....m.................._.
Current transformers:
No. & Size............____.......................
Ser. No......................--....-..................
Ser. No...........................__............__...
"
Ser. No...____.....__............__............__._..
N'!
17295
Type of Wiring:
. ..~1:>-'"
Armored Cable ..--.........---............-
\
Non-Metallic .............--......---.........
Knoh & Tuhe___...._____________....____...._
Rigid Conduit .._____......._________________
MetalIlc Tubing --.....-----...-----.......
Raceway ......................._......__..._
Circuits. Light..................................._..
"-.-.~
Utlllty....__....____________.__......__._________.
J-Ieat ....-..................................-..-..
Range .._...........................__.............
\~
Water Heater ...............................
Motor ..._........................................
Dryer......__.....__.................____..........__
Furnace ..............._.........'_..__.._..... .....:
\
Total wad........_____........._____.. Ser. No.......--.....-.....---..,.--....----......... Total .........--.---...-...:~........---....
~:.:.2:.2~~~~~=~=~f:~.
-:=_;_~_-::~_______-_-_~_______-..___-___-_----.----.::~:_~:__:_~_~~~~:.__.~____--:--'--..--m--::.""iZJl;LZ~=:::::
NOTICE-Current must not be turned on until Certificate of Inspection haa been issued. It work is to be con.
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
N?
17295
Address....._.....__........._.........__............._._.....................__...............__.............__..................._...........Date..._......_.._......_..........-.-....-.....--...-.....
Owner........_.._......................._.........._......_......_.._........................._.........................._......Tenant........_...........................................-...............
Wiring Contractor _._......._.....___................__...___.......__..._................................................................. By..........................................._..................
NOTICE-Current must not be turned on until Certlf1cate of Inspection has been issued. If work Is to be con-
cealed due noUce must be given the Inspector so that work may be inspected before concealment.
}\'<, ,~::-:
.,....'
,
~ -"IM
-';.,..
Olympic Printers, Inc.
.0
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N?
15084
Port Angeles, Washlngtonn_nnnn___m__________hn_______________nh____________, 19_____m
In aceordance 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.
~ /. ./ . I
::' ~;~~<:i:?~~!~~2~=:;~,O?:'.~'':~::::~=~:::
- (/
Light Outlets........o......................_..._.__..
Service, volts ...........n.....................__...
Receptacle Outlets..........____......_......___.
No. wires _...........n..............._.........
Dryer, KWj ................__._..........____........
Range, KW munhmo.__mnmm..
Water Heater:
if .;
KW.mm__m__'______________
Size wiresm...........m......................
Main fuse '''00
Enclosure ....._m...............
Type of wiring:
Entrance Cable ....h_......................
Heal: RW.............................
Rigid Conduit "..-..............n..........
Metallic Tubing .m....nn....u.........
Current transformers:
No. & Size.......................................
Motors: size, volts and phase:
Ser. No..............................................
Ser. N 0......._.........._.................._.......
Ser. No..................._..........................
Type of Wiring:
Armored Cable ..nm......
Non-Metallic ......h........_...._...........
Knob & 'l'ube...............................n
Rigid Conduit .........................__....
Metallic Tubing .......m...._............
Raceway ........h................................
Circuits, LlghL.....................hmn..........
Utility ...........n...............n.........h..__
Heat
Range ..........._............._......._...........
Water Heater n.........................n..
Motor ..._........................................
Dryer...._.........................._..................
Furnace .....h..................._.mnm.....
Total I..oad.....h............_........ Ser. No.............................................. Total ....00.................................
Remarks: ____n_"___~,e_d.___f..L'r':_J:::_L_g_"_j:;l______h___________m_nmn__hnn_____0.___00_______00__0._______0._____000.0._____
00---00----00---------------------00-------00--------00------00----------0.00---------0.-0.0.0.----------000.00---.7mj-n------_7-,nnn--.;;mnh---n.:------nnnn---
Permit Fee Treas. Receipt ,. ..' '1' i I
$ N B I' ,_,I,-._.-,.c. . .. -.-,'-...,)
_n_______m______m_____m_______. 0._______________00_____00000 y ________nn...n.hn--n.nooo.-------m------n_________.oooooon
NQTICE-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?
15084
Date called for Inspection............................n.............h................._..........n..........h...h.................u......................o.........n......._....__.............h
Prelimlnary1nspectiondateB..................._....................................__................................................................................................................
Total Load .....u......_u.............................................._...._...................._ ....
Inspectloncompleted..._.................._......_...................................._....._...............__......................._................................__..........._........_......._
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II,
1M 3.72 Olympic Printers, Inc.