HomeMy WebLinkAbout334 Rhodes Rd - BuildingPREPARED 3/03/10 8 05 17 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/03/10
ADDRESS 334 RHODES RD SUBDIV
TENANT NBR KENNETH C GILBERTSON
CONTRACTOR ALL WEATHER HTG COOLING INC PHONE (360) 452 9813
OWNER KENNETH C GILBERTSON PHONE (360) 457 4768
PARCEL 06 30 15 3 4 0075 0000
APPL NUMBER 10 00000017 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99 01 3/03/10
MECHANICAL FINAL TIME 01 00
March 2 2010 9 43 58 AM 1pangrle
ALL WEATHER HEATING COOLING 452 9813
MECHANICAL FINAL HEAT PUMP
AFTERNOON
COMMENTS AND NOTES
(3/2/2010) Linda Pangrle Ken Gilbertson inspection Page 1
From Jpotter <jpotter @olypen.com>
To <Lpangrle @cityofpa. us>
Date 3/1/2010 11 37 AM
Subject: Ken Gilbertson inspection
Please set up the Ken Gilbertson inspection for Wednesday March 3rd He will be home
334 Rhodes Rd
Electrical Permit: 10-00019
Mechanical Permit: 10 -0017
Phone 457 -4768
thank you
Jenny Smith
Dispatcher
All Weather Heating and Cooling
302 Kemp Street
Port Angeles WA 98362
(360) 452 9813
Application Number
Application pin number_
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
operty ZOhing
Application valuation
Application desc
3 ton Heat pump 15 KW furnace no load change
'Owner Contractor
KENNETH C GILBERT.H0a
334 RHODES RD
PORT ANGELES
(360) 457 4768
Permit
Additional desc
Permit pin number 159228
Pe Fee 56 00
Issue Date .1/08/10.
Expire 7107/10
Qty Unit Charge Per
1 00 56 0000 ECH EL LVT THERMOSTAT
Fee summary
Permit Fee Total
Plan Check Total
Grand- Total.
SERVICE
•ROUGH IN-
FINAL
COMMENTS'
WA 983621917
ELECTRICAL ALTER RESIDENTIAL
-INSPECT-10N TYPE7==
1000000019 Date 1/08/10
423233
334 RHODES RD
06 30 1 3 4 0075 0000
ELECTRICAL ONLY
RS9 RESDNTL SINGLE FAMILY
0
/12.1 tv
hz to
--ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
ALL WEATHER HTG COOLING INC
302 KEMP ST
PORT ANGELES .WA 98362
(360) 452 9813
DATE
Plan Check- Fee
Valuation
Charged Paid Credited
_56 00 56 00 oo.
.00 00 00.
56 00 56 00 00
RESULTS
'1 2.
Due
Extension
56 00
00
00
00
00
0
Signature_of awner_or Electrical Contractor X Date
INSPECTOR.
KENNETH C GILBERTSON
334 RHODES RD
PORT ANGELES
(360) 457 4768
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 10 00000017 Date 1/06/10
Application pin number 311201
Property Address 334 RHODES RD
ASSESSOR PARCEL NUMBER 06 30 15 3 4 0075 0000
Tenant nbr name KENNETH C GILBERTSON
Application type description MECHANICAL APPL PERMIT
Subdivision Name
Property Use
Property Zoning RS9 RESDNTL SINGLE FAMILY
Application valuation 8611
Application desc
HEAT PUMP INSTALLATION
Owner Contractor
WA 983621917
ALL WEATHER HTG COOLING INC
302 KEMP ST
PORT ANGELES WA 98362
(360) 452 9813
Permit MECHANICAL PERMIT
Additional desc HEAT PUMP INSTALLATION
Permit pin number 159202
Permit Fee 64 80 Plan Check Fee 00
Issue Date 1/06/10 Valuation 0
Expiration Date 7/05/10
Qty Unit Charge Per Extension
BASE FEE 50 00
1 00 14 8000 EA ME FURN /HP /FAU OR 5 TON 14 80
Fee summary Charged Paid Credited Due
Permit Fee Total 64 80 64 80 00 00
Plan Check Total 00 00 00 00
Grand Total 64 80 64 80 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 fora period of 180 days
after the work has 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 ofa 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.
I 0 0 =OA L %"c:6 0 w. t C244 9 4.. 6/A)
Date Print Name Signature of Contractor or Authotized Agent Signature of Owner (if owner is builder)
T.FormsBuilding DivisionBuilding Permit
FOUNDATION
Footings
Stemwall
Foundation Drainage Downspouts
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 Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Slab
Wall Floor Ceiling t,
MECHANICAL.
Heat Pump Fumace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
T Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 4815 Electrical Inspections 417 4735
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I I ESA.
Landscaping I I SHORELINE.
FINAL Date Accepted by
FINAL Date 3_3 I j Accepted by :J L
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical 417 -4735 r
Construction R.W PW Engineering 417 -4831
C
Fire 417 -4653
3
Planning 417 -4750
Building 417 -4815
01/06/2010 14 41 13604525177 ALL WEATHER HEATING
BUILDING PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES
Attn: Building Permit Technician
321 E. Fifth St, Port Angeles, WA 98362
(360)417 -4815 fax (360) 417 -4711
PROJECT ADDRESS
tt. l ev4
e cc es 2.r 9
Applicant p re v
Property Owner LED
Property Owner's Address
Contractor
Contractor's, Address ,Z
License Pak oe_ {C,
ebaixo
Parcel Number k l=i 2cc 1
&i ect Type 8 Brief Description: Residential ❑Multi- famfly
Check all that apply
New Construction
,o Addition
o Remodel
o Repair
Demolition
o Re -roof o House o garage o other
?idlest System Meat pump o wood burning stove o gas fireplace
o Other
1) Expires b_° 4 .1Q. E -mail u� oven o1
b
Floor Areas Existing (sa. ft fposed(sq. ft.)
Basement
1 Floor
2 Floor
3' Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Max. height of proposed structures ft. Occupancy group
Will a lawn sprinkler system be installed? Occupant load
Will a fire sprinkler system be installed? Construction type
Phone
Phone
WPr�g
Phone
Lot
'For,City U1-0-1.() e Only
Date Received
Permit '10 1'L
Date Approved
Commercial
Zoning
per sq. ft.
of bedrooms
of full baths
of half baths
o Industrial
o tear off re -roof o lay over one layer
pellet stove other
TOTAL VALUATION 0, bl 1
Total footprint of structures sq. ft. Lot size sq. ft. Lot coverage
Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios,
and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage
have road and completed this application and know it to be true a d correct. I am authorized to apply for this permit and undo
that it is my responsibility to determine w t permits am m irod, a d to obtain permits prior working on protects.
Date()1 IthII(7 Print Nam Signature
T Forme /BuHdIng Division/Btdg Pormit.doc U�
PAGE 02/04
Application Number
Application pin number
T rOperty Address
ASSESSOR PARCEL NUMBER
Application
Subdivision Name
Property Uge
Property Zoning
Application valuation
Application desc
3 circuits for 15 KW furnace
Own
dILBERTSON KENNETH C
334 RHODES- RD
PORT ANGELES
Permit
Additional desc
_Permit loin number
PeTriii:t."
Is-sue Date
-Expiration Date
Qty
1. 0.0
__.2. 00_
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
Unit Charge Per
73 5000_ECH
2 6000 ECH
'INSPECTION TYPE
_DITCH_
SERVICE
ROUGH IN
_FINAL
COMMENTS
WA 983621917
Charged
78 '70-
00
78 70
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
10 00000014
318100
334 RHODES RD
06 30 15 3 4 0075 0000
SLECTRICAL ONLY
RS9. RESDNTL SINGLE FAMILY
0
3 ton heat pump
Contractor
SIMPSON ELECTRIC
243036 W HWY loa
PORT ANGELES
(360) '45.7 9270
ELECTRICAL ALTER RESIDENTIAL
159160
78 70
1/06/10
7/05/10
Plan Check Fee
Valuation
EL BRANCH ,CIRCUIT WO/FEEDER
EL ECH ADDNT BRANCH CIRCUIT
Paid Credited
78 70 00
TO
78 7-0- -00
DATE.
b
f-2/)7b
RESULTS
Date 1/06/10
WA 98363
Due
00
Extension
7.3_50
5 20-
00
00
.0
Signature of owner or Electrical Contractor X Dale
INSPECTOR.
CITY OF PORT ANGELES PERMIT APPLICATION I JAN 6 2009
Building Division/Electrical inspections
321 East Fifth Street P.O. Box 1 150 Port Angeles Washingtaf
Ph: (360) 417 -4735 Fax: (360) 417 -4711 DISPECTIORS
Owner 1 1mation
Name: 4....4/1 .-i 1
Meiling Ail ss: =z, Li h a l es
City A- State: al& Zip: E+.
Phone:4f5 9- 7tW.g_Fax:
License# Exp.-
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 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 Sgiiare Ft
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Signaty of er, electrical contra or electrical administrator
Unit Char%
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
11030
35.20
73.50
110.30
Dated: 6 Vc
RECEIVED
Date: 1 4 1Q
,1 2 Single Family Dwelling Multi Family or Commercial*
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: .3 _V aR h o n5
Building Square Footage:
Description of above 9 rp n M E t a 01 _ri I _._2
Ceeh Check
F Credit Gerd
/Q
0110112010
Commercial Addition Alteration Remodel Repair* 8
Contractor Information
Name: S Seat f c icer`e. Li- e..
City: �T'`! State: .4s.)7 Zip:
Phone: 5 D FaN
License 0I Exp •5 o q']3 e
gtx Total (Qty Mullioned by Unit Charge
'1i 5 0
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.C., RCW Chapter 19.28, WAC. Chapter 296.468, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
01/06/2010 14 41 13604525177
City of Port Angeles Permit Application
Building DivietonfEtoctilcai Inspections
321, East Fifth Street P.O. Box .1150
'Port Angele6 Washington, 98362
Ph: (380)417.47'35 Fax :360)417.4711
Date; I)1 [1-1 1 L_
&2 §Ingie.Farnlly Dwelling
.Multi- Family or Commercial"
Commercial Addition/Alteration Remodel Repair*
Plari Review May Be Require Please Complete EI meal Plan 'Review Information Sheet
Job Address: K i`1 Pc--.,
Building Square Footage; 7
Descr flan b ye_L__:i0.'J, L AD ht7� (Y and Q11 1 ►aI Y1�C1
Owner. Information
'Name:
Mailln. Address:
City 1:A•.`..&p r.. Phone3.11 -14 4.
License E><p;
yinit Charge
$119,90
5145.50
5 204.60
262.20
372,50
2;60
73.50
2.60
92,70
110,30
146.70
"$167,90
5 95.90
88,20
5. 95.90
63,90
63.90
119.90
102.30
$.110,30
35,20
73,60
110.30
56,00
State: (ll Zip
ax:
Total (Qtt! MuIUolled by Unit Chan J
Sennce/Feeder 200 Amp,
ServIce/Feeder 201.400 Amp,
5 Service/Feeder 401.600 Amp,
Service/Feeder 601.1000 Amp.
5 ServicelFeeder over 1000 Amp,
Branch Circuit WI Service Feeder
Brener Circuit W/O Service Feeder
5 Each Addllionat Branch Circuit
Temp. Service/ Feeder 200 Amp.
Temp, Service /Feeder 201-400 Amp.
3 Temp, Servrce/FeadDr 401 -600 Amp,
Temp, Service/Foeder 601 -1000 Amp,
Portal to Portal Hourly
Sign/Outline Lighting
Signal Circuit/ Limited Energy Commercial, Addldonal 1500 $5.00
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi- Family Dwelling
Manufactured Homo Connection
Renewable Electrical Energy 5KVA System or Less
First 1300 Square FL
5 Each Additional 500 Square FL or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Thermostat
$10 Total
Owner as defined by RCW,19,28.281 (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 properly Is for sale, rent or lease, Permit dxplres after six months o/ 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 lewa, N.E.C. RCW. Chapter 19.26, WAC. Chapter 296.468, The City of Port Angeles Municipal Code, and Utility Specifications.
Signature of owner, etectrkal contractor or electrical administrator Cash
OVJ W)
ALL WEATHER HEATING
RECEgyE
JAN 7 2009
ELECTRICAL
INSPECTIONS
Contractor,' formation
Namtra
Malilr. Addrss:
City' r 6," 1 .11
Phone: ie.. ����i,�
License Exp ftta
a' .S6
a
S
r
V;) Credit Card
State: Pr' Zip: 2_
no Flo
PAGE 04/04
33y
Owner Business:
Owne Business Address:
~ential S
~eat KW
o aseboard 0 Furnace/Boiler
~ eatpump 0 Other I
o ommercial/lndustrial ioad
~otal Connected load
Lattach breakdown)
'!,',otal Motor load
'tttach breakdown)
DetalslDescription:
CITY OF PORT ANGELES
LIGHT DEPARTMENT
PERMIT NO. ';;>y'tll
/ /.:2lhz.-
, ,
ELECTRICAL PERMIT
DATE
~
o READY FOR
INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
Phone:
Sq. Ft.
o New Construction
~ Remodel
~ Service update/alter/repair
o Add/alter circuits
o Auxiliary power
(list below)
o Special equipment
(list below)
!if Overhead
o Undergro~2-VO
Voitage /
l'!10 03.0'
Service size ~ Amps
o Temporary
~ Acfcfr' ~
.
W.S. No. Service
Cap city: 0 O.K. 0 Not O.K.
o itch inspection O.K.
~ 1J ough-in/cover O.K.
;;..4 .K. to connect service
I (}II- . 0 inal O.K.
z'
M:tv
~
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
Permit/Receipt No.
~ftf
New Meters
--
L
Ins aller:
No~ify the Department of City Light by Street Address and Permit Number when ready for inspection. Work
must not be covered or eiectrically energized before inspection and O.K. for covering or service has been given
by he Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457-0411, EXT. 158 or EXT. 224.
I ~ NO OCCUPANCY OR USE ESTABLISHED UNOER THIS PERMIT if ~
Inspector A Dunt pard
WH E - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
.
o
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION,AND ELECTRICAL PERMIT
A :3'/0
PERMIT NUMBEA
FEE E EIPT UMBER
'.
I
TOTAL FEE
I
.3[)~
/f/ll v"t:
2&3 cyAl
CONT. Lie. NO.
~.
TIME TO COMPLETE
NO. STORIES
LEGAL OCCUPANCY
elECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Site Addr 55
331 RHoDES Rn
CORRECT ADDRESS IS RESPONSIBILITY OF APPLICANT
PEAMITS WITH WRONG ADDRESSES ARE CANCELLED
Owner Installation By If/JLilORSEN S EIErrT)?J C
Owner's Address / 1/ r: ~t/' II lit ' Installers Address . /42 fa UJ 1/ m
Day PhoJe 4.17''}- /0 FlIP / , Installers Phone 4Ji' 7 - ?A'.o 3
APPlicaubn is hereby made for Permit to install Electrical Equipment as follows: !f1/)fI /1 F hi /J ,#I4E
Wiring Method
NUMBER AMP
USE :>F CIRCUIT CIRCUITS PER
CIR
LIGHT
LIGHT
CONV .NIENCE
CON V NIENCE
APPUJ NeE
DISHWI'SHER
OI$PQ Al
. RANG
OVEN
WATEI HEATER
LAUN[ RY
120V
'0
240V
100R
30
FEE
USE OF CIRCUIT
NUMBER
CIRCUITS
AMP
PER
CIR
120V
'0
.
240V
100R
30
FEE
SIGN
50 VOLTS
OR LESS
-
MOTOR
MOTOR
. .MOTOR
, FIRE ALARMS
BURGLAR ALARM
MISC,
DRYE
FURN CE
GAS.. IL
FURN CE
ELECT IC
ELECT IC HEAT
REINSTALLATION LIGHT FIXTURE #
SUB TOTAL FEE
ENERGY FEE
BASIC FEE
TOTAL FEE
SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
~ /)-'J AMP / {If PHASE
SIZE OF SERVICE ENTRANCE CONDUCTORS
ELECT IC HEAT
A,C.U,IIT
FEEDE
SERVI E
;7190 - v7 dD
I SUB-TOTAL
4/0 1h, Z//J AWG
SIZE OF GROUND"";; SIZE OF ENTRANCE SWITCH a.b 0
.
I certlf) 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.
DateA plication made utiLI S"zt ,19/?!: By ~~".r.J ~ .J/& ,- -,
hfNTRACTOR OR OWNER (OR AUTHORIZED AGENT)
Pe mission is hereby given to. do the aboye described work, according to the conditions hereon and according to the approved plans and
specifi ations pertainmg thereto, subject to compliance with the Ordinances of the C ty of Port Angeies:,. -'. .' -:.. :-:' ~?{ ";
. /'" --?' /J J DIR~OR OF CITY LI?,HT ' . " '.
. --I~ /" /q8s By / V;'A!JH2 -' ,".,'
Date P rmit Issued '-.,.} U, .
.' PLANS APPROV;~D 1/ '.~' I . - -..
Notify Department of City Ught by Street Address and ermit Number when ready for inspection. Work must not
be covered or current turned on before inspection and .K. for covering or service has been given by Inspector in
Writing on Permit Placard. A.. Permits Phone: 457-0411 Ext. 158. !
Wt RNING I
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
WHITE - Original CANARY - Duplicate PINK - Triplicate WHITE CARD. Inspector's Report
,.." vuoll oo,..,TCC<:: ''''f''
t~ ~'':-
..l ,~~, ~
DATE OF VISIT
h
1.'(-8'C
7 -8" - .., J
~"/~~5S-
MADE BY
j,
.\
I
'.
'.
1),1'%'
/, '(' ~
11f' ~
, -
REPORT OF INSPECTOR
~ 1:'''_
.
O.K. FOR COVERING ~
'. .... -.
O.K. TO CONNECT SERVICE
... \ ....
. "
~ ~IN~d)~K:-"" "
~.
.\
.,
. '
REMARKS
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CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
:$ 2J:~BER
.
I 30.00 . ~ -'/~
TTAL FEE d
CONT. Lie. NO. TIME TO COMPLETE NO. STORIES LEGAL OCCUPANCY
I ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Site Address - 33 ~ .0l?~~ ~I '
;il '. CORRECT AIj9..JESS...)S73f''),;,.'''U'''''' '( C?F APPLICANT PERMITS WITH WRONG ADDRESSES ARE CANCELLED
Owner,; /),;?4/4ul!/ ~~~ Insi~lIation By ~
owner'~:~ddreS5 /1. Installers Address
Day Ph ore 7~ -Y;7 6> Y , " Installers Phone
Applicatlo~.Is hereby made for Permit to install Elect~ic:al Equipment as follows:
-I L(J1J'-dth.1 ~nu- _$-?1<.{> (=?OU'L) ~t~
I
.
US,OF CIRCUIT NUMBER AMP 120V 240V NUMBER AMP 120V 240V
CIRCUITS PER 10 100R FEE USE OF CIRCUIT CIRCUITS PER 10 100A FEE
CIR 30 CIR 30
L1GHTI SIGN
L1GHTI 50 VOLTS
OR LESS
CONVENIENCE MOTOR
I
CONveNIENCE 'MOTOR
,
APPLl~NCE MOTOR ,
DISHVIASHER , FIRE ALARMS
, p
, BURGLAR ALARM
DISPOSAL
,
, MISC,
RANGE
I
OVEN~
WATEr HEATER
LAUNDRY ,,,
,
DRYER , , REINSTALLATION LIGHT FIXTURE # _1~l;1,~ y,.:-.. if.
,
FUAN-i'CE SUB TOTAL FEE T
GAS. OIL
FURN~CE ENERGY FEE
ELEC1RIC BASIC FEE
ELEctAIC HEAT
TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
,.
A.C. uNIT ""ll?rJ AMP PHASE
I
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
,
, --
SERVICE AW.G.
I
,- I SUB, TOTAL
SIZE OF GROUND SIZE OF ENTRANCE SWITCH
Wiring Method 1&-/ ~a.diu
V .
.
Date pe;m~i?! /tfS
,
I
I
I
~RNING
_, uJ __u,m_ ,.,_
I cerliflthat the work to be performed under this permit will be done by the installer and'
I .~ /~/'l~r- .
Date Application made 1ILA/ It, ,19 By
I CONTRACTOR OR OWNER (OR AUTHORIZED AGENT)
Permission IS hereby given to do the above described work, according to the conditions hereon and according to the approved plans and
speCiflbatlons pertaining thereto, subject to compliance with the Ordinances of the Ci.ly of Port Angeles.
DIRECTOR OF CITY'LIGHT
BY' 7J,(<I~~u, 4
PLANS APPROVED /".
Notify Department 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 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
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REPORT OF INSPECTOR
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DATE OF VISIT MADE BY REMARKS
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7. O.K. FOR COVERING
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FINAL O.K.
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