HomeMy WebLinkAbout127 E Park Ave - BuildingCITY OF PORT ANGELES
PUBLIC WORKS UTILITIES
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 10 00000010
Application pin number 720260
Property Address 127 E PARK AVE
ASSESSOR PARCEL NUMBER 06 30 10 5 0 0568 0000
Tenant nbr name QWEST
Application type description PUBLIC WORKS UTILITES
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
50 buried phone cable RCP #10 01
Owner Contractor
PITTIS TTE JACK N /PENNY A
P 0 BOX 3041
PORT ANGELES WA 98362
Fee summary
T' \Policies \I 102 15 10/081
Charged Paid Credited
Date 1/07/10
EXCEL UTILITIES CONSTRUCTION
54 W MISTY LN
PORT ANGELES WA 98362
(360) 452 1110
Permit RIGHT OF WAY
Additional desc 50 BURIED PHONE CABLE #10 01
Permit pin number 159129
Permit Fee 150 00 Plan Check Fee 00
Issue Date 1/07/10 Valuation 0
Expiration Date 7/06/10
Qty Unit Charge Per Extension
1 00 150 0000 ECH PW RW CONST EXCAVTION OTHER 150 00
00 150 0000 ECH RIGHT OF WAY PERMIT 00
Special Notes and Comments
Traffic control plan to be submitted to and approved by the
City prior to the start of work Permit fee does not include
surface restoration Work to be in accordance with attached
detail
Due
Permit Fee Total 150 00 150 00 00 00
Plan Check Total 00 00 00 00
Grand Total 150 00 150 00 00 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
CALL 417 -4831 FOR UTILITY INSPECTIONS 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
PW UTILITIES (Engineering Division)
WATERLINE METER
SEWER CONNECTION
SANITAR Y
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB GUTTER
DRIVEWAY APPROACH
BACK -FLOW DEVICE
T \Policies \1102.15 [10/08]
RESIDENTIAL
CONSTRUCTION R.W PW/
ENGINEERING 417 -4831
FIRE 417 -4653 I
PLANNING DEPT 417 -4750 I
BUILDING 417 -4815
PERMIT INSPECTION RECORD
YES NO
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES I NO
CONSTRUCTION R.W
PW ENGINEERING'
I FIRE DEPT
I PLANNING DEPT
I BUILDING
PREPARED 8/16/06 9 10 27 INSPECTION TICKET PAGE 7
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 8/16/06
ADDRESS 127 E PARK AVE SUBDIV
TENANT NBR PENNY PITTIS
CONTRACTOR PHONE
OWNER PITTIS TTE JACK N /PENNY A PHONE
PARCEL 06 30 10 5 0 0568 0000
APPL NUMBER 06 00000407 RES REMODEL
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL3 01 6/23/06 JLL BUILDING FRAMING TIME 13 00
6/23/06 DA PENNY 457 3078 THIS IS A DECK INSPECTION
06/22/2006 01 09 PM DYASUMUR
06/23/2006 04 00 PM JLIERLY
post and beam under stringer /2x block at joist and beam
intersection /no brad nails on guard rail /hand and guard
rail on stairs/j11
BL99 01 8/02106 JLL BUILDING FINAL TIME 13 00
8/02/06 DA 08/01/2006 04 10 PM DYASUMUR
PENNY 457 3078
08/02/2006 04 49 PM PBARTHOL
NEEDS HANDRAIL
BL99 02 8/14/06 JLL BUILDING FINAL
8/14/06 DA 08/11/2006 08 53 AM PERMITS
PENNY PETTIS 457 3078
08/11/2006 09 25 AM JLIERLY
08/14/2006 04 00 PM JLIERLY
no brad nails in newwel post /deck screws in hanger to be
replaced with 16d commons and bolt connection block to
beam/j11
BL99 03 8/16/06 LL BUILDING FINAL TIME 13 00
9 f 08/15/2006 03 58 PM DYASUMUR
PENNY 457 3078
COMMENTS AND NOTES
BUILDING DIVISION
CITY OF PORT ANGELES
Correction Notice
Job Located at t 2.9
Inspection of your work revealed that the following is
not in accordance with the codes governing the work in
this jurisdiction
Od- 2
kt4 s o�1
6 -ieL1 1
1)
These corrections must be made and are not to be
covered until reinspection is made When corrections
have been made, please call
for inspection
Date
Inspector for Building Division
nn MAT RFMAVF T41IC TAO.
PREPARED 8/14/06 13 18 36
CITY OF PORT ANGELES
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
ADDRESS 127 E PARK AVE SUBDIV
TENANT NBR PENNY PITTIS
CONTRACTOR PHONE
OWNER PITTIS TTE JACK N /PENNY A PHONE
PARCEL 06 30 10 5 0 0568 0000
APPL NUMBER 06 00000407 RES REMODEL
BL3 01 6/23/06 JLL BUILDING FRAMING TIME 13 00
6/23/06 DA PENNY 457 3078 THIS IS A DECK INSPECTION
06/22/2006 01 09 PM DYASUMUR
06/23/2006 04 00 PM JLIERLY
post and beam under stringer /2x block at joist and beam
intersection /no brad nails on guard rail /hand and guard
rail on stairs /j11
BL99 01 8/02/06 JLL BUILDING FINAL TIME 13 00
8/02/06 DA 08/01/2006 04 10 PM DYASUMUR
PENNY 457 3078
08/02/2006 04 49 PM PBARTHOL
NEEDS HANDRAIL
BL99 02 8 14/06 J.. BUILDING FINAL
%'a IP 08/11/2006 08 53 AM PERMITS
fps I�`riv, PENNY PETTIS 457 3078
ig 08/11/2006 09 25 AM JLIERLY
COMMENTS AND NOTES
PAGE 4
DATE 8/14/06
PREPARED 8/02/06 9 36 29 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 8/02/06
ADDRESS 127 E PARK AVE SUBDIV
TENANT NBR PENNY PITTIS
CONTRACTOR PHONE
OWNER PITTIS TTE JACK N /PENNY A PHONE
PARCEL 06 30 10 5 0 0568 0000
APPL NUMBER 06 00000407 RES REMODEL
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL3 01 6/23/06 JLL BUILDING FRAMING TIME 13 00
6/23/06 DA PENNY 457 3078 THIS IS A DECK INSPECTION
06/22/2006 01 09 PM DYASUMUR
06/23/2006 04 00 PM JLIERLY
post and beam under stringer /2x block at joist and beam
intersection /no brad nails on guard rail /hand and guard
rail on stairs/j11
BL99 01 8/02/06 JLL BUILDING FINAL TIME 13 00
1 08/01/2006 04 10 PM DYASUMUR
‘94— PENNY 457 3078
o f COMMENTS AND NOTES
PREPARED 6/23/06 13 25 29 INSPECTION TICKET PAGE 5
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 6/23/06
ADDRESS 127 E PARK AVE
TENANT NBR PENNY PITTIS
CONTRACTOR
OWNER PITTIS TTE JACK N /PENNY A
PARCEL 06 30 10 5 0 0568 0000
APPL NUMBER 06 00000407 RES REMODEL
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL3 01 6/23/06
SUBDIV
PHONE
PHONE
BUILDING FRAMING TIME 13 00
PENNY 457 3078 THIS IS A DECK INSPECTION
06/22/2006 01 09 PM DYASUMUR
COMMENTS AND NOTES
BUILDING DIVISION
CITY OF PORT ANGELES
Correction Notice
Job Located at
Inspection of your work revealed that the following is
not in accordance with the co es govern'n• he work in
this jurisdiction
9,Ar L S,
.IPok..(1-. S L r)'h
t)ST( G iAghti l T L kLe, ae .41A1
N I c ,�4-aoarz 47` 4O S
l Q
DO NOT REMOVE THIS TAG
G
These corrections riius -mod -are not to be
covered until reinspection is made When corrections
have been made, please call -f-
for inspection
I
Date it) Q3 k 0 .J C-L..
Inspector for Building Division
PREPARED 6/22/06 11 03 25 INSPECTION TICKET PAGE 11
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 6/22/06
ADDRESS 127 E PARK AVE SUBDIV
TENANT NBR PENNY PITTIS
CONTRACTOR PHONE
OWNER PITTIS TTE JACK N /PENNY A PHONE
PARCEL 06 30 10 5 0 0568 0000
APPL NUMBER 06 00000407 RES REMODEL
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL3 01 6/22/06
BUILDING FRAMING TIME 13 00
PENNY 457 3078 THIS IS A DECK INSPECTION
06/21/2006 08 21 AM DYASUMUR
COMMENTS AND NOTES
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 06 00000407
Application pin number 361382
Property Address 127 E PARK AVE
ASSESSOR PARCEL NUMBER 06 30 10 5 0 0568 0000
Tenant nbr name PENNY PITTIS
Application type description RES REMODEL
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 9000
Contractor
PITTIS TTE JACK N /PENNY A OWNER
P O BOX 3041
PORT ANGELES WA 98362
Owner
Permit BUILDING PERMIT RESIDENTIAL
Additional desc
Permit pin number 76216
Permit Fee 193 75 Plan Check Fee 77 50
Issue Date Valuation 9000
Expiration Date 11/13/06
Qty Unit Charge Per Extension
BASE FEE 95 75
7 00 14 0000 THOU BL -2001 25K (14 PER K) 98 00
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
05/15/2006 10 09 AM SROBERDS No land use issues noted
Electrical load calculations and elctrical permits are
required
Other Fees
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged Paid Credited
T \Policies \1102_15 building permit inspection record05 wpd [1/4/2005]
Date 5/17/06
STATE SURCHARGE 4 50
Due
193 75 193 75 00 00
77 50 77 50 00 00
4 50 4 50 00 00
275 75 275 75 00 00
Separate Permits are required forelectrical 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 orwork is suspended or abandoned
fora 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
nstruction.
s. R#Q 16
Sign'}ture of Contractor or Authorized Agent Date Signature of Owner Of owner i builder) Date
CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS.
CALL 417 -4807 FOR PUBLIC WORKS UTILITIES
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
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR 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 FURNACE DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
COMMERCIAL HOOD DUCTS
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING /LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT
BUILDING PERMIT INSPECTION RECORD
YES 1 NO
FINAL
FINAL
SEPA.
ESA.
SHORELINE.
417 -4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W PW/ CONSTRUCTION RW
ENGINEERING 417 -4807 PW ENGINEERING
FIRE 417 -4653 I I I I FIRE DEPT
PLANNING DEPT 417 -4750 I J I I I PLANNING DEPT
BUILDING 417 -4815 (,�0b I J /4' I I BUILDING
T \Policies \l 102_15 building permit inspection record05 wpd [1/4/2005]
DATE ACCEPTED BY.
DATE ACCEPTED BY.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES I NO
I I I
I I I
I I I
Applicant or Agent:
Owner•5P
Address: Ja 7 L PC lL 4) P- City (1 /4/1
Architect/Engineer
Contractor
City Zip
ZONING
Fa 404
LEGAL DESCRIPTION Lot:A. L y 11 Block. L‹ Subdivision. 7 Sco.,a. n
CLALLAM COUNTY PARCEL NUMBER. 6.30 o (5 0,57 anti Y
Address:
PROJECT ADDRESS Poss. 4.)e-
TYPE OF WO
Residential
Multi family
Commercial
Repair
BRIEF DESCRIPTION OF THE PROJECT
RK.
New Constr
Addition
Remodel
Sign
COMMERCIAL/RESIDENTIAL. Occupancy Group
No. of Stones. Lot Size. Existing Sq. Ft.
Total lot coverage
PLANNING USE ONLY
ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other
T•1FORMS\BldgPermitform.wpd Applicant:
BUILDING PERMIT APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST B
COMPLETE to be accepted for review If you have any questions, call
PERMITS (360) 417 -4815 FAX(360)417-4711
State License
Re -roof Stove
Move Garage
Demolition tk Deck Li On
Other
Phone:
Phone.
Phone:
Exp
96 367
Zip 96862
SIZE/VALUATION
SF /SF
SF /SF
SF /SF
TOTAL VALUATION 1 cz��tl
FOR OFFIC
Date Rec.•✓,
Permit a
Date kpproved:
Date Issued:
Phone:
Occupant Load. Construction Type:
Proposed Sq Ft. TOTAL Sq Ft.
Date: S a- in 6,
APPROVALS
PLAN
BLDG
DPWU
FIRE.
OTHER.
VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant.
This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit
Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section
RI05.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to
apply for this permit and understand that it is my responsibility to determine what permits are required not the City's, and that I
must obtain such permits prior to w
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CITY OF PORT ANGELES Construction Plans
The Issuance of this permit based upon these plans, specifi-
cations and other data shall not prevent the building official
from thereafter requiring the correction of errors in said
plans, specifications and other data, or from preventing
building operations being carried on thereunder when in
violation of all codes and ordinances of this jurisdiction.
Approval Date 47
lo
WALK
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By .11CC
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FEE RE9EIPT NUMBER
f
CITY OF PORT ANGELES '.
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
co 95
PERMIT NUMBER
.
I
TOTAL FEE
I
, :.1
. p.
Site Addiess
I
1ttfR
00
LEGAL OCCUPANCY
PERMITS WITH WRONG ADDRESSES ARE CANCELLED L>
,"_ .In~tallatlon BY.' 12' ~~ t~;c U4.eivJ IJE{L.
I );(;7 (.'?,c;t/~ Installers Address ~--~ ~;,'~ ---:-
Day Phone 451,- :,o-t'h Installers Phone ' .4.S Z- "l ,')"Z.
Application is hereby made for Permit to'lnstall Electrical Equipment as follows: ";0\3,- "AN E:-L I N St\o~ (VJ ,'toJr
~O~T.l!~. NO:.:>.. . TIME TO: COMPLETE NO; STORIES
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
\'';'
-,
Owner
.
II 2.;;' Q';,.,;-\- I I"M- L\'(W;:";.lzc O\J\\..J.,c..~H.~'\.\s ') , ,
Wiring Method -~ /I ~L)'
. . .' /
USE OF CIRCUIT~' NUMBER AMP 120V. . 240V NUMBER AMP 120v, 240Vl
CIRCUITS PER 10 100A FEE USE OF CIRCUIT CIRCUITS PER 10 100R FEE
CIR 30 CIR 30
LIGHT I &, ..-r /b ,,. SIGN
LIGHT 50 VOLTS
OR LESS
CONVE;NIENCE' '2 -z.o ./' MOTOR ,. .
-
CONV~NIENCE . MOTOR I .
APPLIANCE I. 30 /' ,- MOTOR .
D1SH'hI~S.HER FiRE ALARMS .
OISPO~AL BURGLAR ALARM
RANGE MISC,
OVEN
WATEFA HEATER
LAUNQRY .
DRYER REINSTALLATION LIGHT FIXTURE #
FURNlfcE SUB TOTAL FEE
GAS-OIL-
FURN~CE ENERGY FEE
ELEC AIG ..
BASIC FEE
ElEC'JfAIC HEAT
TOTAL FEE
ELEctRIC HEAT , SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
..
A.C. UNIT / / AMP PHASE
FEEOItR V V SIZE OF SERVICE ENTRANCE CONDUCTORS
" . .
SERVICE AW.G.
I SUB-TOTAL ;t .!!- 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 i
Date Application made Oc..-\b~ 'Z. <), I . .19.E:f:- By
o TRACTOR OR OWNER (OR AUTHORIZED AGENT)
Pqrmlssion Is hereby given to do the above ~e5cribed work, according to the conditions ere n and according to the approved plans and
specihications pertaining thereto, subject to compliance with the Ordinances of the City ~t Port Angeles. .....,.
, DIRECTOR OF CITY LIGHT
B~
PLAN APPROVED
Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not
be covered or qurrent 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. .
,
"
.
Date R;ermft Issued
WARNING
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
OL_YMPlC PRINT':RS, INC.
REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
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11- ;,.(. -{ if /jJ ;f 5' O.K. TO CONNECT SERVICE
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CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? L6396
~- - ....., "-.. .....
-. t'--' (I' ...
Port Angeles, Washlngtonmm__...:::mm....~:__:mm__m...m...m.m...__. 19__000:..
II). 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 m!;~;1?:.--.}E..m--!.~--LtL--..---:;i..--..'--'m--'mm.m. Occupancy.__~,,~__:~m.__.__,___..nmm.m.__
". (.' "./.' /
~7:::~.~;~~~~j~t:~~;?;.::::::::j~.;.:dh\~~>.r:6~;~~;~::~::::::::.,~,..'.~~:::::::::~::::::::::::::::~:::::::::::::::::::::
Light Outletsm_....m./.................._..... Service, volts ....!..n:.:.::.~n..':.....~:..~:.... Type of Wiring:
: (> '1
Rece~tacle Outlets.m....jm___............... No. wires ..n...!........................"";;...... Armored Cable ................----.......-..
C SI 1 ~"./",.; 0 ( 4-' Non-Metallic ................................-
:::::. ::.,'.'.')...:;::.'..:.'.'..:....--........::.... M:~n ;u::sZ;::~:::::'::?:::::::::~:: Knob & Tube.....,........__..........__,__.
Water Heater: "
I '11 i
~W...........~:!-...~......h._..._..
. J"' ,,-:11<
Heat: 'KW.h..n..O;::.....~.n.!.':.".?...::.............
Enclosure ........:........n._...n.....___.._.....
Type of wIrIng:
Entrance Cable .m.'h'
Mot~rs: size, volts and phase:
Rigid Conduit ...............................
Metalllc Tubing ....____...__.__...........
Current transformers:
No. & Size.n..n.....__..n...........
~.......................--.............................n..
Ser. NO........................n.....................
Ser. No. ....h..............................h..._...
Ser. No. un..n._nn..n..n.h..............n....
Rigid Conduit ......................__......'
Metallic TubIng hn.n.....h.............
Raceway ..........,..~............_._..._
CirCUits,. LlghU'J:f......--.....................
~:~:tyjlE:::::::::::~::::::::::::::::::::
Range ..:::?____...__........................__...
@
Water Heater ..._...............m..mh.
Motor _......................nn...n....n......
Dryer n..~n.......u............n.................
Furnace ..n.....un.__......n.'_........_..._......
,'~
Total Load....m...................... Ser. No. ................._........h.._............. Total .t2~~:~......._......h...........
Remarks: __mumm__<::!"-__1..:!..:.,!:::.m___../__,-!.1:'!,'__,,~.__t(,._m.u__=u__mmummmmu__um.mmummmmuumm__.
m--_.m-----.----______'u__mm.mm.-fly.~'______j/9--~le,..f.kA).!.:uD.Tmm.m--m--m__mmmm________m__.m__
.;~~~';~~.m----m.--.umuumu;~:~:.;:~;~~m.~J~-<!~~~yu--m:~--mum000__
$,<u__ZL;,~l::L.m.mm.-- NO.m......................... By ,jz.,::,:,:____,~;.__.~.::~'.:.m:__:__:'~-::~/!.u::__:__:,....,
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con.
cea.led 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?
16396
A,ddress..................._..................................................................................................................Date..._......_.........._.........._......_......_......._
Qwner..................................._.........._.................._......................._...................................Tenant..........................._........................................
Wiring Contractor ..................................._..................................................................................... By..............................................._......n......
NOTICE-Current must not be turned on unttl CertIfIcate of Inspection haa been issued. If work Is to be con-
cealed due notice must be given the Inspector so that work may be inspected before concealment.
.....,.._-,~ t:l..;..t",T'''. Ine.