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Home My WebLink About415 Vashon Ave - BuildingPREPARED 7/27/10 8 14 07 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 7/27/10 ADDRESS 415 VASHON AVE SUBDIV TENANT NBR ROGER /BARBARA J SANTEE CONTRACTOR PHONE OWNER ROGER /BARBARA J SANTEE PHONE (360) 417 6663 PARCEL 06 30 10 5 0 0752 0000 APPL NUMBER 10 00000627 RE ROOF PERMIT BNOP 00 BUILDING PERMIT NO PR FEE REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL99 01 7/27/10 JLL BLDG FINAL July 26 2010 3 41 58 PM 1pangrle BARBARA 417 6663 BUILDING FINAL RE ROOFED THE HOUSE D NOTES CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc TEAR OFF RE ROOF THE HOUSE Owner ROGER /BARBARA J SANTEE PO BOX 3096 PORT ANGELES WA 98362 (360) 417 6663 Structure Information 000 000 Permit BUILDING PERMIT NO PR FEE Additional desc RE ROOF THE HOUSE Permit pin number 167841 Permit Fee 151 75 Issue Date 6/17/10 Expiration Date 12/14/10 Qty Unit Charge Per 4 00 14 0000 THOU Other Fees Fee summary Charged Date Permit Fee Total 151 75 Plan Check Total 00 Other Fee Total 4 50 Grand Total 156 25 Print Name T:Forms/Building Division/Building Pennit 10 00000627 Date 6/17/10 325356 415 VASHON AVE 06 30 10 5 0 0752 0000 ROGER /BARBARA J SANTEE RE ROOF RS7 RESDNTL SINGLE FAMILY 5282 Contractor OWNER TEAR OFF RE ROOF THE HOUSE BASE FEE BL -2001 25K (14 PER K) Plan Check Fee 00 Valuation 5282 Extension 95 75 56 00 STATE SURCHARGE 4 50 Paid Credited Due 151 75 00 4 50 156 25 00 00 00 00 00 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 has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that 1 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. ',C) 6-)7 o /D I Ili PAk w( z °e Signature of Contractor or Authorized Agent PLEASE REPORT SALES TAX ON YOUR EXCISE TAX FORM TO THE CITY OF PORT ANGELS' (LOCA110N CODE 0502) Signature icir)4 tip/ 7 -Z7- 10 wner (if owner is builder) 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 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 Date Accepted By 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 MECHANICAL. Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting PLANNING DEPT Separate Permit #s SEPA. Parking Lighting 1 ESA. Landscaping 1 SHORELINE. T:Forms /Building Division /Building Permit Comments FINAL Date Accepted by FINAL Date Accepted by 2 5 FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE r Ill Inspection Type Date Accepted By Electrical 417 -4735 ____Z Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 I "7_7 I Q P 6 Applicant R (3/ s„ Property Owner Q Tee Property Owner's Addres to ci,x 3611, Contractor ,53/1 Contractor's Address License PROJECT ADDRESS LOS V4 _s h 01 Parcel Number Project Type Brief Description. Residential Multi- family Commercial Check all that apply New Construction Addition Remodel Repair Demolition )(Re -roof XHouse garage other 'tear off re -roof .0 lay over one layer Heat System Heat pump wood burning stove gas fireplace pellet stove other Other Floor Areas Basement 1 Floor \7/ 2nd Floor 3 Floor Garage Carport Covered Porch Deck Shed Other Total footprint of structures Site Coverage the amount of impervio and other impervious surfaces (see PA Max height of proposed structures Will a lawn sprinkler system be ins lied? Will a fire sprinkler system be ins fled? BUILDING PERMIT CITY OF PORT ANGELES Attn Building Permit Technician 321 E. Fifth St. Port Angeles WA 98362 (360) 417 -4815 fax (360) 417 -4711 Existing (sq. ft.) Proposed (sq. ft.) Expires A Occupancy group Occupant load Construction type APPLICATION Print in ink TOTAL VALUATION sq ff. s• ft. Lot size ace on a parcel including structures paved 17 94 135 for exemptions) Signature For City Use Only Date Received 11 lb Permit IO Date Approved Phone y /7- 666.3 Phone Phone E -mail Lot M-c_A-eri al nor I have read and completed this application and know if 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, and to obtain permits prior to wqr fq �ng on profits. Date 4„,-/6-- /0 Print Name ?oc e T.Forms /Building Division /Building permit applicdtion Zoning per sq ft. f bedrooms o full baths #of':fbaths Industrial 26 5282 L ways sidewalks patios Site coverage Clallam County Assessor Treasurer Property Details 64925 ROGER/BARBARA J Page 1 of 5 Clallam County Assessor Treasurer Property Search Results 64925 ROGER/BARBARA J SANTEE for Year 2010 2011 Property Account Property ID Geographic ID Type. Tax Area: Open Space: Historic Property* Multi Family Redevelopment: Township Range Location Address: Neighborhood: Neighborhood CD Owner Name Mailing Address. Owner Name Mailing Address. Taxes and Assessment Due Year 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 Statement ID 47197 47197 47197 47197 47197 47197 47197 47197 47197 47197 2009 649252008 2009 649252008 64925 0630105007520000 Real 0010 N N N PA 121 PORT ST CNTY H2 L Land Use Code DFL Remodel Property 415 E VASHON AVE PORT ANGELES WA Cycle 5 Res 10955130 ROGER /BARBARA J SANTEE PO BOX 3096 PORT ANGELES WA 98362 ROGER /BARBARA J SANTEE PO BOX 3096 PORT ANGELES WA 98362 Property Tax Information as of 06/17/2010 Amount Due if Paid on. En_ Taxing Jurisdiction ST SCH STATE SCHOOL CC -GEN COUNTY PORT PORT PORT ANG PORT ANGELES SD #121 SCHOOL DISTRICT #121 NTH OLY LIB NORTH OLYMPIC LIBRARY HOSP #2 HOSPITAL #2 WSMET PK DIST WILLIAM SHORE MET PARK CITY_STORMWATER CITY STORMWATER WEED_CONTROL WEED CONTROL 2010 47197 TOTAL. ST SCH STATE SCHOOL CC -GEN COUNTY Legal Description Agent Code Section Mapsco Map ID* Owner ID Ownership Exemptions. Owner ID Ownership* Exemptions. First Half Base Due $245 70 $130 76 $18 38 $302.73 $318.24 $38 00 $53 64 DIST $17 06 $36 00 $0 82 $1161.33 $282.68 $143 06 PUGET SOUND CO -OP COLONY 2 ADD LOT 14 BL 7 11 N N 50415 100 0000000000% 50415 100 0000000000% Second Half Base Due Penalty Interest Base $245 69 $0 00 $0 00 $24 $130 75 $0 00 $0 00 $1 $18 37 $0 00 $0 00 $1 $302 73 $0 00 $0 00 $3C $318.24 $0 00 $0 00 $31 $37 99 $0 00 $0 00 $C $53 63 $0 00 $0 00 $t $17 07 $0 00 $0 00 $1 $36 00 $0 00 $0 00 $C $0 81 $0 00 $0 00 9 $1161.28 $0.00 $0.00 $11€ $282.68 $0 00 $0 00 $5€ $143 06 $0 00 $0 00 $2E http. /vpn.clallam. net: 8084 /propertyaccess /Property.aspx ?cid =0 &year= 2010 &prop_id =64 6/17/2010 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDiNG DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 OWNER/APPLICANT PROPERTY LOCATION ROGER & BARBARA SANTEE 415 VASHON 415 VASHON Lot: 14 Port Angeles, WA 98362 Block: 7 [] Long Legal 360/808-1919 Subdivision: PSCC 2ND T: S: Parcel No: 063010500752000 CONTRACTOR ARCHITECT EVERWARM N/A 257151 HWY 101 Port Angeles, WA 98362-0000 , 98360-0000 360/452-3366 360/000-0000 PROJECT INFO Project Value: $3,154.00 SFD Units: 0 Commercial: 0 Project Type: PROPANE INSERT SFD SQ FT: 0 Industrial: 0 Occupancy Type: RESIDENTIAL Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: RS7 PROJECT NOTES INSTALL PROPANE INSERT RECEIPTf19175 FEES ASSESSMENT Building Permit: $0.00 Misc Fee 1: $0.00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $0.00 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 Sign: $0.00 TOTAL FEE: $35.00 Plumbing: $35.00 AMOUNT PAID: $35.00 Mechanical: $0.00 BALANCE DUE: $0.00 Radon: $0.00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All previsions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date ~ ~g O ~,~f~- e's bu' de ) Date T:\PLANNING\FORMS\1102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES I No FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (L1GHT DEPT) SEPARATE PEPdMIT: # PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE tq'-o*-- ( BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'$: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LiGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 ~g~-- ~.-~ t~ ~/ BUILDING T:\PLANNING\FORMS\1102.15 [4/2002] ~ pORT,~/ [ FOR OFFICIAL USE ONLY: °"'~ BUILDING PERMIT - APPLICATION Pe~it,:j Date ApproVed: Date Issued: The Building Permit Application must be filled out completely. Please type or print in ink. If you have any questions, please call 417-4815 Applic~t or Agent: Phone: Address: ff~- MdS~',oo City: '~Orf ~eAe5 Zip: 5 ~chitect~ngineer: Phone: Con.actor ~ee~'~ License ~: Exp: Phone: Address: City: Zip: PRO~CT~D~SS: 41 ~- ~h~ ~NG: LEG~ DESC~PTION: Lot: Iff Block: ~ r Subdivision:p~'~ ~ ,~o c~,~ d ~ CL~L~ CO~TY P~CEL N~BER: ~'~& -I O - $'~ ~ Card Holder'~ame: Billlng Address: City:. Credit Card g: Exp. Date: ~SA MC T~E OF WO~: SI~UATION: ~Residential ~ New Com~. m Re-roof m Wood-stove SF. ~ $. /SF. ~ Multi-h~ly ~ Addition ~ Move ~ Garage SF. ~ $. /SF. = $ ~ Comercial ~ Remodel ~ Demolition ~ Deck SF. ~ $ /SF. = $ D Repak ~ Si~ ~e~ ,~{~,~ TOTAL VALUATION $~ ~ BmEF OESCmPTION OF THE PROJECT: '}n$~ ~&~ $'4.~.'~'~'[ COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: __ ConstmctionType: No. of Stories: __ Lot Size: % LotCoverage: % Existing Lot Coverage: /sq. ft. + Proposed Lot Coverage: /sq. ft. = TOTAL LOT COVERAGE: /sq. ft. PLANNING USE ONLY: APPROVALS: PLAN Notes: BLDG. DPW FIRE ESA/Wetland(s): [] Yes [] No SEPA Checklist required? [] Yes rn No Other: OTHER BUILDING PERMIT APPLICATION SUBMITTAL: Your application and site plan must be filled out completely to be accepted for review. The Building Division can provide you with more detailed information on the application and plan submittal requirements. Your completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division. 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: Your plan check fee is due at thc 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, this 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 107.4 of the Uniform Building Code, current edition). 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, and I am authorized to apply for this permit. I understand it is not the City's legal responsibility to determ~e what permits are required; it remains the applicant's responsibility todeterminewhatpermitsarerequiredandtoobta~uc~I CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date ~-~ '- [ *"~> ~ ~-~' Time Received by /~ ~/' (phone, person) Location of Work to be inspected Name of person requesting inspection. Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. / ~ </~'~ Sewer Foundation Framing Chimn,~~l SewerExcav. Other INSPECTION NOTES: Inspected: Date ~: /' j Time By Remarks:. RESTORATION REQUIRED ...... YES_ NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved []Gravel []Asphalt []PCC I~Other [] Repaired by City Work Order # [] Repaired by Permittee [] COMPLETE [] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date ~ "//- O ~ Time Received by (phone, person) Location of Work to be inspected z..///,~--- Name of person requesting inspection _~-'~d3. v~_~_~-%~-~7~_ Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): ~ Permit No. I ~ ~ ~"~ Sewer Foundation Framing Chimney Plumbin~.~ewerExcav. INSPECTION NOTES: /~/~ Inspected: Date '~ ~ L } -- ~--~- Time By Remarks: RESTORATION REQUIRED ...... YES. NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved []Gravel I--]Asphalt [~PCC []Other [] Repaired by City Work Order # [] Repaired by Permittee [] COMPLETE r--I No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 ELECTRICAL PERMIT PERMIT NO. ..:;-tb/tj 7/z~hb DATE Installed By: o READY FOR INSPECTION license Number: o WILL CALL FOR INSPECTION Phone: Site Address: Owner/Business: Phone: Owner/Business Address: Sq. Ft. ELECTRIC HEAT o BASEBOARD KW _ o FURNACE KW _ o HEAT PUMP KW o FAN/WALL KW ~ RESIDENTIAL o COMMERCIAL o NEW CONSTRUCTION o REMODEL ~'ADD/ALTER CIRCUITS o SERVICE UPGRADE/REPAIR o TEMPORARY SERVICE o RISER o OVERHEAD SERVICE ~ UNDERGROU% ~VICE VOLTAGE: /2.y z u . , l(1 rjJ 0 3 ~ SERVICE SIZE AMPS FEEDER SIZE AMPS DetailslDescription: .... fAtuJ rc l(uJ ad- 'M~ . W.S. No. SERVICE SIZE CAPACITY: o O.K. 0 NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o OVERHEAD SERVICE APPROVED o CHANGE SERVICE WIRE o OTHER o Ditch Inspection O.K. o Rough-in/cover O.K. o O.K. to connect service o Final O.K. Site Address: Permit/Receipt No.. Installer: ~ . . NewM:::- ~ & Notify Port Angeles Cit.{U9ht by Street Address and Permit Number when ready for inspection. Work must not be covered before inspection and O.K. r covering has been given by the electricai inspector in writing on either the Wiring Report or on the Building Pe . PHONE 457-0411, EXT. 224. . Eiectrii Inspector WHITE - File by address NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ jij"~i:,-<?;S! Permit Fee PINK - Top: Eng, Bottom, Customer GREEN - Top: Meter Dept., Bottom: City Hall OLYMPIC PRINTERS INC. . Site Address: Installed By: Owner/Business: Owner/Business Address: ELECTRIC HEAT D BASEBOARD KW _ D FURNACE KW _ D HEAT PUMP KW D FAN/WALL KW y;, Lil- CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles. WA 98362 (206) 457-0411 PERMIT NO $" /s/ t:. ~ .6.. ? k..s- , DATE ELECTRICAL PERMIT . Sq. Ft. D READY FOR INSPECTION License Number: D WILL CALL FOR INSPECTION Phone: Phone: ~RESIDENTIAL D COMMERCIAL D NEW CONSTRUCTION ~REMODEL ~ ADD/ALTER CIRCUITS D SERVICE UPGRADE/REPAIR D TEMPORARY SERVICE D RISER D OVERHEAD SERVICE D UNDERGROUND SERVICE VOLTAGE: D1~ D3~ SERVICE SIZE FEEDER SIZE AMPS AMPS Details/Description: ~~-- . W.S. No. SERVICE SIZE CAPACITY: D O.K. D NOT O.K. ACTION REQUIRED: D CHANGE TRANSFORMER D INSTALL SERVICE POLE DATE ENGR. D OVERHEAD SERVICE APPROVED D CHANGE SERVICE WIRE D OTHER D Ditch Inspection O.K. 1JfJ"'1 'fJ Rough-in/cover O.K. D O.K. to connect service ,.(jr ~ Final O.K. Installer: permit:;;Yb New Meters - Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report or on the Building Permit. PHONE 457-0411, EXT. 224. .KIf ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ r ~ - Electrical Inspector Permit Fee . WHITE - File by address OLYMPIC PRINTERS INC. PINK - Top: Eng, Bottom, Customer GREEN - Top: Meter Dept., Bottom: City Hall CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N? 15939 Y - d '7 ;.;? Port Angeles, Washlngton________._..........._........:___...________...___...___.___., 19..___.__ 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- mission is hereby granted to d6 electrical work as listed below. Address ___.v.,?-=.e.___%~!!~--------.n..n--..--...--------. Occupancy___.___.-h.t!~.______....___...._____. Owner ..__c.&.-'::cr.~_...___~,,___::.______.!".n___.____ Tenant._____.__.m.m.__._.__.__.____________m.h.....__..___________h... Wiring Contractor ...(.3.!.r:'.&:.~.2___.e.q:C..fA.&::.....n...m. By...__.__.____________________________.____________.______....____..__ j< 6 / d v / Ci---,'./.c; Light Outlets___.................n........__.._..... Service, volts ........___......:..._......_.......... Receptacle Outlets...L.:&c2........__... No. wires ..._.....:2........................... n'ye" KW ____.......f........nn__n__.___n__n Size wlres..../;0~<:?..~ Range, KW___.____-"'.__?:____._____.__..n. Main fuse ....~t2{L!f................ . C..7/,4 Enclosure ....n..m_..m_..m.....__.n Water Heater: ./ KW.__..__n.:1,!n.L________.______________ Heal: KW__......:'2..@,,__B/3.__.__________.__ Type of wiring: Entrance Cable ......_....______._... Motors: size, volts and phase: ...../d~.J.~..........______________...... ....-I--.g.r~1J..~--...--............... Rigid Conduit ........_....00......_... Metallic Tubing .........__....._.......... Current transformers: No. & Size.............__n_n._._.._n....._..n Ser. NO............n.__.....____..n...___n__..___.. Ser. No. ...00._00000000...0000..00....00__..00.00..00. Ser. NO.nn__n....n_....n........................ Type of Wiring: Armored Cable ..__...m.................._. .Meta1l1e .............................__n Knob & Tube.___..._n_.n.................._ Rigid Conduit ..................__..__....... Metallic TUbing ____m...._............... Raceway .._.....................n.....___..._ Circuits, LighLL.G.__......m.............n Utlllty ./..:.9....__.....__...................__. '~ I.Ieat ...L....._n.............................. Racge __...."'3.................__.............. "') Water Heater _..~..._.................... Motor .___...................___........._00...... Dryer _______~,................___..__...______.__ Furnace ...._._..................'_................._. Total Load__....____...__..._....m... Ser. No. ..m.___.._.m._n_m_.....___........__. Total .....~'...n_._......._...n... Remarks: n.__.___........?~,=6-.;:";;t;;;.--n..c.,.6,2-<f.~.e...K:~--.--...----.-------------.m--__m.___________._______________........__ Permit Fee $...___..{;.~:.<?____...m.m No............................. By ___.it..fi...?f>,Il~~_,__. " '''. NOTICE-Current must not be turned on until Certificate of Inspecliorl.,.has been issued. It work Is to be eOD- cealed due notice must be given the Inspector so that work may be inspected-before concealment. Treas. Receipt NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION \ ELECTRICAL PERMIT N~ 15939 Address.___.__.______.__..___.._...._____...___..._......._..__.........___...___....__....._.........._................__n.______._____.....Date..._.............._.._.................._......__........ Owner .........._.........00....00......._.........._.............._.._.......00..._....00...........000000.00.._____.__.......... Tenant....nn_nn___n_..__m.............___...._...........n...._... WiringContractor____.__....____..___.....___h__.........~...............--..--...........---..--....-------.--.-..__....__._..___.__.By............................................................._ \ NOTICE-Current must not be turned on until Certificate of Inspection has been Issued. If work Is to be con- ce~~~d due notice must be given-the Inspector so that work may be inspected before concealment. .' lU _ O\vmDic Printers, Inc.