HomeMy WebLinkAbout427 Vashon Ave - Building CITY OF PORT ANGELES
i Vaal DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
NMI N M I 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 11- 00000164 Date 3/01/11
Application pin number 455884
Property Address 427 VASHON AVE
ASSESSOR PARCEL NUMBER: 06- 30- 10 -5 -0 -0760 -0000- REPORT SALES TAX
Application type description RES REMODEL
Subdivision Name on your state excise tax form
Property Use to the City of Port Angeles
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 8000 (Location Code 0502)
Application desc
REPLACE EXISTING INTERIOR STAIRS
Owner Contractor
ELDORA H PEDERSON TTE MICHAEL RIVERS CONSTRUCTION
427 VASHON AVE 840 W 6TH ST
PORT ANGELES WA 983626312 PORT ANGELES WA 98363
(360) 457 -5637 (360) 808 -7050
Permit BUILDING PERMIT RESIDENTIAL
Additional desc REPLACE EXISTING STAIRS
Permit pin number 181735
Permit Fee 179.75 Plan Check Fee 116.84
Issue Date 3/01/11. Valuation 8000
Expiration Date 8/28/11
Qty Unit Charge Per Extension
BASE FEE 95.75
6.00 14.0000 THOU BL- 2001 -25K (14 PER K) 84.00
Other Fees STATE SURCHARGE 4.50 k
1fr
Fee summary Charged Paid Credited Due
Permit Fee Total 179.75 179.75 .00 .00
Plan Check Total 116.84 116.84 .00 .00 1'
Other Fee Total 4.50 4.50 .00 .00 L) 1 1
Grand Total 301.09 301.09 .00 .00 V1
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 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.
/41, 2
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECT IONS
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
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 FINAL Date Accepted by
AIR SEAL:
Walls
Ceiling
FRAMING: 3 -16-11
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 FINAL Date Accepted by
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping SHORELINE:
I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical 417 -4735
c\I Construction R.W. PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
L--
T:Forms /Building Division /Building Permit
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BUILDING PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES
t For City Use Only:
Is._ ag Attn: Building Permit Technician Date Received 2- Z-'( 1
321 E. Fifth St., Port Angeles, WA 98362
(360) 417 -4815 fax (360) 417 -4711 Permit i tw
Date Approved
d
Applicant D& SG�-4 U g�- Ph 2 —D Zco
Property Owner EL-'D 9gp ?EDE(L Phone 54 3
Property Owner's Address 1+2.7 E. `1, tat• 7
Contractor /1;l 1 CN ikEt. (Lk V Ea-S Phone
Contractor's Address (G -+1. S; Po•-16-6 3
License Expires E -mail
PROJECT ADDRESS 47-7 E. UM.S{+(ot1
Parcel Number Lot Zoning
Project Type Brief Description: yResidential Multi family Commercial Industrial
Check all that apply Met 4) p^
New Construction p WOE OE L— Y-I ST 1(06 A T 1 (L
Addition
);Remodel
Repair
Demolition
Re -roof House garage other tear off re -roof lay over one layer
Heat System Heat pump wood- burning stove gas fireplace pellet stove other
Other
Floor Areas Existing (sq. ft.) Proposed (sq. ft.)
Basement per sq. ft.
1 Floor
2nd Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION 1,00-
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
Max. height of proposed structures ft. Occupancy group of bedrooms
Will a lawn sprinkler system be installed? Occupant load of full baths
Will a fire sprinkler system be installed? Construction type of half baths
I have read and completed this application and know it 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 prio t working on projQcts
Date Z- .7% 1( Print Name 1)0P P Signature Vtet-fil-e7
T:Forms /Building Division /Building permit application
Clallam County Assessor Treasurer Property Details 64927 ELDORA H PEDERSO... Page 1 of 4
Menem County Assessor Treasurer
Property Search Results 64927 ELDORA H PEDERSON TTE for Year 2011 2012
Property
Account
Property ID: 64927 Legal Description: PUGET SOUND CO-
OP COLONY 2 ADD
LOT17BL7
Geographic ID: 0630105007600000 Agent Code:
Type: Real
Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11
Open Space: N DFL N
Historic Property: N Remodel Property: N
Multi Family Redevelopment: N
Township: Section:
Range:
Location
Address: 427 E VASHON AVE Masco:
PORT ANGELES, WA
Neighborhood: Cycle 5 Res Map ID: 2
Neighborhood CD: 10955130
Owner
Name: ELDORA H PEDERSON TTE Owner ID: 45554 I.
Mailing Address: 427 VASHON ST Ownership: 100.0000000000%
PORT ANGELES, WA 98362 -6312
Exemptions: A,
i Taxes and Assessment Details rr
Property Tax Information as of 02/22/2011
Amount Due if Paid on: NOTE: If you plan to submit payment on a future date, make sure you enter the date and f
click RECALCULATE to obtain the correct total amount due.
First Second
Half Half
Base Base
Year Statement ID Taxing Jurisdiction :Amt. Amt. Penalty Interest: Base Paid Amount Due
2011 158902 ST SCH STATE SCHOOL $261.94 $261.94 $0.00 $0.00 $0.00 $523.88
2011 158902 CC -GEN COUNTY CLALLAM $144.61 $144.59 $0.00 $0.00 $0.00 $289.20
2011 158902 SD #121 SCHOOL DISTRICT #121 $342.41 $342.39 $0.00 $0.00 $0.00 $684.80
2011 158902 CITY PORT ANG- CITY OF PORT ANGELES $333.83 $333.81 $0.00 $0.00 $0.00 $667.64
2011 158902 PORT PORT OF PORT ANGELES $20.35 $20.35 $0.00 $0.00 $0.00 $40.70
2011 158902 NTH OLY LIB NORTH OLYMPIC LIBRARY $60.65 $60.64 $0.00 $0.00 $0.00 $121.29
2011 158902 HOSP #2 HOSPITAL #2 $59.36 $59.36 $0.00 $0.00 $0.00 $118.72
2011 158902 WSMET PK DIST WILLIAM SHORE MET PARK DIST $18.04 $18.04 $0.00 $0.00 $0.00 $36.08
2011 158902 CITY STORMWATER CITY STORMWATER $36.00 $36.00 $0.00 $0.00 $0.00 $72.00
2011 158902 WEED_CONTROL WEED CONTROL $0.82 $0.81 $0.00 $0.00 $0.00 $1.63
2011 158902 TOTAL: $1278.01 $1277.93 $0.00 $0.00 $0.00 $2555.94'
2010 47199 ST SCH STATE SCHOOL $259.32 $259.31 $0.00 $0.00 $518.63 $0.00
1 2010 47199 CC GEN COUNTY CLALLAM $137.99 $138.01 $0.00 $0 00 $276.00 $0.00
2010 47199 SD #121 SCHOOL DISTRICT #121 $335.89 $335.88 $0.00 $0.00 $671.77 $0.00
2010 47199 CITY PORT ANG CITY OF PORT ANGELES $319.52 $319.52 $0.00 $0.00 $639.04 $0.00
2010 47199 PORT PORT OF PORT ANGELES $19.40 $19.39 $0.00 $0.00 $38.79 $0.00
2010 47199 NTH OLY LIB NORTH OLYMPIC LIBRARY $40.10 $40.10 $0.00 $0.00 $80.20 $0.00
2010 47199 HOSP #2 #2 $56.61 $56.61 $0.00 $0.00 $113.22 $0.00,
2010 47199 WSMET PK DIST WILLIAM SHORE MET PARK DIST $18.02 $18.01 $0.00 $0.00 $36.03 $0.00
2010 47199 CITY_STORMWATER CITY STORMWATER $36.00 $36.00 $0.00 $0.00 $72.00 $0.00
2010 47199 WEED CONTROL.- WEED CONTROL $0.82 $0.81 $0.00 $0.00 $1.63 $0.00
2010 47199 TOTAL: $1223.67 $1223.64 $0.00 $0.00 $2447.31 $0.00
Values
Improvement Homesite Value: N/A
Improvement Non Homesite Value. N/A
Land Homesite Value: N/A
Land Non Homesite Value: N/A Ag Timber Use Value
Curr Use (HS): N/A N/A
Curr Use (NHS): N/A N/A
http: /websrv8.clallam. net propertyaccess /Property.aspx ?cid =0 &year 2011 &prop_id =64927 2/22/2011
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""s 1�� S The issuance of this permit based upon these plans, specifi-
��G cations and other data shall not prevent the building official
i from thereafter requiring the correction of errors in said
ec AA plz. specifications and other data, or from preventing
Wes- C� ��'(4 OV C a., b;ilr ng operations being carried on thereunder when in
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DRAWN: FEB 2011
FEDORA PEDERSON 427 E. VASHON PORT ANGELES, WA 98362 457 -5637 DON SCHUBA 452 -0207
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427 E. VASHON PORT ANGELES, WA 98362 457 5637 DON SCHUBA 452 020
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
BUILDING PERMIT ISSUED: 6/01/2000 PERMIT NO: 11971
OWNER/APPLICANT PROPERTY LOCATION
427 VASHON
ELDORA PETERSON
427 VASHON Lot: 17
Port Angeles, WA 98362 Block: 7 [] Long Legal
360/457-5637 Subdivision: PSCC 2NDADDN.
T: S: Parcel No:
CONTRACTOR ARCHITECT
GREAT NORTHWEST ENTERPRISES N/A
PO BOX 2963
Port Angeles, WA 98362 ' , 98360-0000
206/452-9518 360/000-0000
PROJECT INFO
Project Value: $2,860.00 SFD Units: 0 Commercial: 0
Project Type: RE-ROOF SFD SQ FT: 0 Industrial: ' 0
Occupancy Type: Garage: 0
Occupancy Group: MFD Units: 0
Construction Type: MFD SQ FT: 0
Zoning Use:
PROJECT NOTES ~'~
TEAR OFF/REPLACE WITH METAL ROOFING
FEES ASSESSMENT
Building Permit: $83.25 Misc Fee 1: $0.00
Plan Check: $0.00 Misc Fee 2: $0.00
State Surcharge: $4.50 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $0.00 TOTAL FEE: $87.75
Plumbing: $0.00 AMOUNT PAID: $87.75
Mechanical: $0.00
BALANCE DUE: $0.00
Radon: $0.00
RW SANITARY WATER DWY STORM DRA OTHER
Separate Permits are required for electrical work, utilities, private and public improvements. This permit becomes null and void if work or
construction auto.ed 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 e~amined this application and know the same to be t~ue and correct. All provisions of ~ 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
~.o~ons of any state or local law regulating construc~on or the performance of construction.
S~l~re of Contractor or Authorized A~]ent Date Si~lnature i~f Owner (if owner is builder) Date
BUILDING PERMIT INSPECTION RECORD
CALL 417-~815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE IT IS UNLAWFUL TO COVER,
INSUL4 TE OR CONCEAL ANY F/ORK BEFORE INSPECTED AND ACC~. POST PERMIT IN A CONSPICUOUS LOCATION.
K~P pERMIT CARD AND APPROVED PLANS AT JOB SITE
~sP~c~os TYPE ] OATS I ACC~'~'r~n) COMME~rrs
cJ flORT ~Q
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00001112 Date 11/09/05
511776
427 VASHON AVE
06-30-10-5-0-0760-0000-
MECHANICAL APPL. PERMIT
RS7 RESDNTL SINGLE FAMILY
2000
Owner
Contractor
PEDERSON, TTE ELDORA H
427 VASHON ST
PORT ANGELES WA 983626312
PA SWIMMING HOLE & FIREPLACE S
518 W 8TH ST
PORT ANGELES WA 98362
(360) 565-1163
----------------------------------------------------------------------------
Permit MECHANICAL PERMIT
Additional desc PROPANE INSERT
Permit pin number 65110
Permit Fee 57.65 Plan Check Fee .00
Issue Date 11/09/05 Valuation 0
Expiration Date 5/08/06
Qty Unit Charge Per Extension
BASE FEE 47.00
1.00 10.6500 ECH ME-GAS PIPE 1 TO 5 10.65
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 57.65 57.65 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 57.65 57.65 .00 .00
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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
construct" n. J
Signature of Owner (if owner is builder)
Date
T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD t!/6 - /1 / :J-.
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
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEAT PUNW 1 FURNACE 1 DUCTS
GAS LINE II-IO-Of) ...l L \..
WOOD STOVE 1 PELLET 1 CHIMNEY
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W. 1 PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 - PLANNING DEPT.
BUILDING 417-4815 J /-f1.'" -- ~ BUILDING
T:\Policiesll 102_15 buildmg permit mspectlOn record05.wpd [1/4/2005]
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BUILDING PERMIT - APPLICATION
FOR OFFICIAL USE ONLY:
Date Rec.: JI-Cf-t!>S
Permit # (3) S - III g...
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Date Approved
Date Issued:
Owner:
Phone:
City: U7f At/titlh} . 1~14 Zip: (J)J6~
, / '
ArchItect/Engineer: Phone: .
Contractor fJ1- fLy 1111 min' !liLt.. State License #Jl/fuJ/JllZJl!ttJxp};J/" j; 7
Address-'-- 5/$ tt4"~#t "Str.ftt City prrf 4nyitJ; uJ1
PROJECT ADDRESS: If ~? 6 tJ Ct.-5 h () Y1 ZONING:
LEGAL DESCRIPTION: Lot: Block: Subdivision:
Address:
Phone: 57P/5 - Ilh?;
Zip: t}l~&;;(
,
/2$-7
CLALLAM COUNTY PARCEL NUMBER:
ORe-roof
o Move
o Demolition
SIZENALUATION:
SF. @ $ /SF. = $
SF. @ $ /SF. = $
SF. @ $ /SF. = $
,D.P.!hfJIJ . TOTAL VAUIATION $ (' J?~p~lJ.tO
1/1fraJ/lu hUll 1/711 it 1l!fff(al1L ~j ~iiII!} --
)(. Stove
o Garage
o Deck
COMMERCIAL/RESIDENTIAL: Occupancy Group:
No. of Stories: Lot Size: Existing Sq. Ft.
Total lot coverage %
Occupant Load:
& Proposed Sq. Ft.
Construction Type:
= TOTAL Sq. Ft.
PLANNING USE ONLY:
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
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 Pennit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the tinle the building pernnt application and construction plans are
submitted. All other pennit fees are due at the time of pennit issuance.
EXPIRATION OF PLAN REVIEW: !fno pernnt 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 R1 05.3.2
of the International BuildinglResidential Code, 2003). No application can be extended more than once.
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CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
Nt?
16839
r- ..., /''7
Port Angeles. Washlngton....__...............L...................__................ 19,.(.__...
In accordance with the City Ordinance to regulate the instaIlation. 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 .....1...f!..'2.______~'!!:_:_.f!..b:f::1../.________...n..__n_______________. Occupancyn....-:t..L.__':>!._._____.n_.__....___.__
Owner '~:t (1/ '}I-~T ______..__.~.n.__.....__ TenanL...____............___....___.....m...._______...___..m__........__
Wiring ~.~~~~~fo;:=:~..~::.eJi~~~.....nnnn... By..____...mn......_____.....mm.n......m..nn_______.......__
Light out1etBm.-2.~.m.m....m._u_u... Service. volts .).<?.9./..,P...y'!"e:.:. Type of Wiring:
-S--O ..3 ,t /
Receptacle Outlets......__m..._..............__ No. wires --...-VJ:;;..~.~;.;/....
Dryer, KW.._..h._?!:..n......__....____n_n_____ Size wires....;.:;;._..._....._..._...__.,...._..
Range, KW hnn/.~mmunm Main fuse u'JJ.t?u~/1.Plf
Water Heater: _____ Enclosure .....6-..-..--...---..---....--...
Kw..m.....?':(...i.p.n.~uu. u'u.
Heat: Kw!}.;)~uP...Q..fv:::u m.m .
Motors: size. volts and ph se:
~~=
Type of wiring:
Entrance Cable __..n........____..__
Rigid Conduit ........_.....___..__
Metallic Tubing m....
Current transformers:
No. & Size.......__....__......._.__........._._.
Ser. No..__.........___________._..________..........
Ser. No. ...n........_...........____________......__
SeT. No....__...._..___......_______.______...____.___
Armored Cable ................__n..........
Non.MetaJHc ........_n____...............__.
Knob & Tubem.um.mmh...m.um.
Rigid Conduit 'hummm'um.mum.
MetalUc Tubing h__............_._.__.....
C irc:::.e::;~~:~~~:~~~~~~~~~~~~~~~~~~~~~~=~~~=
Utlllty,~c;;,uh"ii.mm.mh.mm
::::n::~~~:.~;:::::.::.....:::..::::::
Motor ..._...._._....________............._.......
."")
~r:r:~~:-~~~~~~~~-.:~..~~~~:::..~,~~~~.......~~~~~~:~:~.
Total Load_........___.._.........__... Ser. No. ..____h.................__.___..._______un Total _.~.:6..............__..._.....
. ~/1 .
Remarks: --n__...nm.___740..:R...(...4.~::::___n___.c:..f:;-::?1.~.~!------.---..---..........n.-.---------..---...___....____._____
."
_nu.nn..n_._._n__n__nnn_nn_ndn._n_._n.hd.Uhh_.Uhn_.Un.u._n.hn.._n_nn_.n__.h_u..nn_.___u._-4__~__u._____u.____u____u.___un':~_nu
;~.~3L:2~.______...._______ ::~~.~:..:~.~:~~:.....m By ___:9t;Z/[~~::~.!;;:~,,-~
,.. v
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It 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
J
ELECTRICAL PERMIT
N?
16839
A1dress'::...................................................................__..._.__.._._._._______d._______________._______.________...____Date________________...._.........._......_...~.__._._____.
\
Owner.......l.__.........._d..........._.........._......_.....________..............__..__......._______________..._____._..__Tenant___..___u_.__________.____.____.._..__..._.........................
j ,
)/
".iringContractor.....................................___.______.__..._....................___......__.______.__________._u__...___.__n_.BY______..__...____...____d................................._..
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work 1s to be con.
-. cealed due noUce must be given the Inspector so that work may be inspected before concealment. .
,...
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\.
Olympic Printers, Inc.
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