HomeMy WebLinkAbout214 Whidby Ave - Building Electrical Permit
214 Whidby Ave
12- 1595
i 1�1
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735 <)
Application Number . . . . . 12-00001595 Date 12/13/12
Application pin number . . . 079510
Property Address . . . . . . 214 WHIDBY AVE REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-10-5-0-0930-0000-
Application type description ELECTRICAL ONLY on your excise tax form
Subdivision Name . . . . . .
Property Use to the City of Port Angeles
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY (Location Code 0502)
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
T-stat Furnace and heat pump
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
KENNEDY ROBERT A ALL WEATHER HTG & COOLING INC
214 WHIDBY AVE 302 KEMP ST
PORT ANGELES WA 983626542 PORT ANGELES WA 98362
;
--------- -- ------------------(360)-----------
--452-9813-- �J- -`yy
_F ---
Permit . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 56.00 Plan Check Fee .00
Issue Date . . . . 12/13/12 Valuation . . . . 0
Expiration Date . . 6/11/13
Qty Unit Charge Per Extension
1.00 56.0000 ECH EL-LVT-THERMOSTAT 56.00 1C�f
- -------- --------------------- --------- ---------- --- V
Fee summary Charged Paid Credited Due
----------------- ---------- V
Permit Fee Total 56.00 56.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total , 56.00 56.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
GAEXCHANGEWILDING
do
V stir r
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections c
321 East Fifth Street—P.O.Dox 1150/Port Angeles Washington,98362
Ph: (360)417-4735 Fax: (360)4174711 /
Date: `�1 &2 Single Family Dwelling
"Plan Revi4 Yj Se .equ'red, Pa e Complete Electrical Plan Review Information Sheet
Job Address:
Building Square Footage: SQ
Des ' G n of above
Ownerformati Contr for WIN do
Name: n '� Name: Y Cts
Mellingddres9: Mailing ddress:
City State-zip: City
: State: Zip:
Phone: ax: Phone: Fax:
License#/Exp.+ License W/Exp. 115
Item Unit Charge Get Total(!jy Multiplied by Unit Charge)
Service/Feeder 200 Amp. $120.00 $
Service/Feeder 201.400 Amp. $146.00 $
Service/Feeder 401-600 Amp $205.00 $
Service/Feeder 601-1000 Amp. $262.00 $
ServlcelFeeder over 1000 Amp: $373.00 $
Branch Circuit WI Service Feeder $ 5.00 $
Branch Circuit W/O Service Feeder $ 63.00 $
Each Additional Branch Circuit $ 5.00 $
Branch Circuits 14 $ 75.00 $
Temp.Service/Feeder 200 Amp. $ 93.00 $
Temp.Service/Feeder 201-400 Amp. $110.00 $
Temp.Service/Feeder 401.600 Amp. $149.00 $
Temp.Service/Feeder 601-1000 Amp. $168.00 $
Portal to Portal Hourly $ 96.00 $
Signal Circuit/Limited Energy-1&2 Femlly Dwelling $ 64.00 $
Manufactured Home Connection $120.00 $
Renewable Electrical Energy-5KVA System or Less $102.00 $
Thermostat $ 56.00 $
Note:$5.00 for each additional T-Stat
NEW CONSTRUCTION ONLY:
First 1300 Square FL $120.00 $
Each Additional 500 Square Ft.or Portion of $ 40.00 $
Each Outbuilding or Detached Garage $ 74.00 $
Each Swimming Pool or Hot Tub $110.00 $_
$-Total
Owner as defined by RCW.19.28.261:(1)Owner will occupy the structure for two years after this electrical permit Is finalized.(2)Owner is required
to hire an electrical contractor If above said property is for sale,rent or lease.Permit expires after six months of last inspection.
After reading the above statement,I hereby certify that I am the owner of the above named property or a licensed electrical contractor.I am making
the electrical installation or alteration in compliance with the electrical laws,N.E.C.,RCW.Chapter 19.28,WAC.Chapter 29646B,The City of Port
Angeles Municipal Code,and Utility Specifications and PAMC 14.05.050 regarding Electrical Permlt Applications.
Signatuv,owner,electrical contractor or electrical administrator, ❑ cash ❑ Chock
(.' ❑ Credit Card#
GetaO: ` 1 0710712012
90/60 39Vd 9NIiV3H N3HiV3M -I-IV L/-TSZ9V09CT 86:6T ZTOZ/50/ZT
Building Permit
214 Whidby Ave
12 - 1594
CITY OF PORT ANGELES
r 7�i DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT-BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 12-00001594 Date, 12/12/12
Application pin number . . . 867788
Property Address . . . . . . 214 WHIDBY AVE
ASSESSOR PARCEL NUMBER:- 06-30-10-5-0-0930-0000- REPORT SALES TAX
Application type description RES MECHANICAL PERMIT
Subdivision Name . . . . . On your State excise tax form
Property Use . . . . . . to the City of Port Angeles
Property Zoning . . . . . ... RS7 RESDNTL SINGLE FAMILY (Location Code O$OZ)
Application valuation 4161
Application desc
3TON HEAT PUMP "
Owner Contractor
KENNEDY ROBERT A ALL WEATHER HTG & COOLING INC
214 WHIDBY AVE 302 KEMP ST
PORT ANGELES WA 983626542 PORT ANGELES WA 98362
(360) 452-9813
------------------------------------------------------------------------
Permit . . . . . . MECHANICAL PERMIT
Additional desc 3 TON HEAT PUMP
Permit Fee 64.80 Plan Check Fee .00
Issue Date . . . 12/12/12 Valuation 0
Expiration Date 6/10/13
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 forelectricalwork,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes
null and void if work or construction authorized i¬ 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'lnspecti ons 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.
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 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
FOUNDATION:
Footings
Stemwall
Foundation Drainage/Downspouts
Piers j"f1
Post Holes(Pole Bldgs.)
PLUMBING:
Under Floor/Slab
Rough-in
Water Line Meter to Bldg)
Gas Line
Back Flow/Water FINAL Date Accepted b
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 Pum /Furnace/FAU/Ducts
Rough-In
Gas Line
Wood Stove/Pellet/Chimney
Commercial Hood/Ducts FINAL Date Accepted b
MANUFACTURED HOMES:
Footing/Slab
Blocking&Hold Downs
Skirting
PLANNING DEPT. Separate Permit#s SEPA:
Parkin /Lighting ESA:
Landscaping SHORELINE:
Mamma.
FINAL'INSPEC.TIONS.REQUIRED PRIOR'TO OCCUPANCY/•USE
Inspection`Type' Date Accepted By 1
Electrical " ' 417-4735
Construction-R.W. PW I Engineering 417-4831
Fire 417-4653
Planning 417-4750
Building 417-4815
T:Forms/Building Division/Building Permit
BUILDING/PLUMBING/MECHANICAL PERMIT APPLICATION - SHORT FORM
(To be used for projects that do not require plan review.)
City of Port Angeles Please print in ink, Date Approved
Attn: Building Permit Technician Approved by ��""-
321 E. 51h St., Port Angeles, WA 93362
360-417-4815 fax: 360-417-4711 Credit card payments are accepted Mon-Fri 8-5 pm (no American Ex re
Hours: Mon through Fri 8—5 pm Cash & checks are accepted Mon-Thurs 8:30-4 pm & Fri 8:30-12:30 p
o tat I INoma
E w,A
Property owne Pmy) vEn4ffiw.
� b`
Phone: torn
Property owner's mailing address: 1 A
N AVO.
Contractor's business namem QOWe7 , b�! Phone
or property owner's name if he/she is doin /overseein the wor �. �JZ•�
C tor's 'lin addr s:
Contra c r' I is n e nu b rExpiratioe date: '
UA
(` i
Project Address:
Project Type: Residential u Commercial o Industrial o Multi-family
Project Business me:
(for commercial, industrial, or multi-family projects)
The following permits are usually issued over-the-counter immediately, without the need for plan review,
Complete only the portions of this permit that are relevant to your project,
Re-roof: o house o garage a other
—
c tear off& re-roof ci lay over one layer
(✓) licensed contractor: Submit a copy of your re-roof bid.
Project Valuation $ x(labor& materials, not including sales tax)
Re-side: o house m garage o other
Project Valuation $ ' (labor& materials, not including sales tax)
Repair: (explain the project)
Project Valuation $
'Homeowner: If you will be doing/overseeing the work, then the project valuation will be determined by doubling the
cost of materials, to reflect the value the repair adds to your property.
Cost of materials x 2 = Project Valuation $
T:Forms/Building Division/Building/Plumbing/Mechanical Permit Application--Short Form (Revised 2011)
Page 1 of 2
S0/b0 30 d 9NI173H a3HiV3M -171d LLTSZSV09£T 8£:£T ZTOZ/S0/ZT
Swimming Pool or Spa (�t 24"deep): For prefabricated swimming pool or spa proiects that
o_po#rea ire alan review:,
(✓) Obtain the City of PA handout entitled"Pools&Spas" &follow the requirements.
Project Valuation
Demolition; A demolition permit Is needed when an entire bul/dlnq gets demolished.
What will be demolished? icD house ❑ garage ❑ other
Note: some demolition permit applications need to be reviewed by various City departments, and may take
approximately two weeks to obtain.
(✓) Agree to ensure that all utilities are/will be properly turned off(and capped off if needed)
prior to demolition,
(✓) Obtain (from the City of PA) an aerial view map of the parcel and put an"x"over the structure(s)to
be demolished. Submit the map with this application.
(✓) Obtain (from the City of PA)a copy of the Olympic Region Clean Air Agency(ORCAA)
Demolition Permit Application,
Contact ORCAA at 360-417-1466 to discuss whether or not an ORCAA Demolition Permit will also
be needed.
c yes d no Will the debris be going to the Regional'transfer Station in Port Angeles?
❑yes ❑ No If yes, will a licensed contractor be taking it there?
(✓) If yes, obtain (from the City of PA)a copy of the Waste Disposal Application.
Complete and submit the waste disposal application to the Building Permit'rechniclan, now
(or later if asbestos testing is needed),
Plumbing Permit: (explain the proieot)
Project Valuation 9t
Mechanical Permit: explain the proJect)
Installation of Heat Pump MMI
Project Valuation
I have read and completed this application end know It to be true and correct, I an't 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
working on projects.
Datelall4a Signature
Print Name
Page 2 of 2
SO/90 39Vd 9NIlV31-1 a3H1V3M -1-IV LLT9Z9b09ET 86:ET ZTOZ/S0/ZT
PREPARED 4/01/13, 10:10:29 INSPECTION HISTORY REPORT PAGE 1
PROGRAM BP521L 0/00/00 THRU 0/00/00
CITY OF PORT ANGELES
---------------------------------------------------------------—---------------------------------------------——------------
APPLICATION PROPERTY ADDRESS ASSESSOR PARCEL NUMBER ALTERNATE ID
STRUCTR PERMIT INSPECTION RESULT DATE/STATUS INSPECTOR
-----------------------------------------------------------------—----------—-----------------------------------------------
12 00001594 214 WHIDBY AVE 06-30-10-5-0-0930-0000- 063010500930
000 000 ME 00 MECHANICAL PERMIT ME99 0001 MECHANICAL FINAL 1/15/13 APPROVED JLL
REQ COMM: January 15, 2013 9:08:17 AM pbarthol.
REQ COMM: Karen 452-9813
RES COMM: January 15, 2013 4:16:29 PM jlierly.
L
ELECTRICALWORKPERMITAPPLICATIO?`,.
Installation description
Job wired by &Electrical Contractor ❑Owner ❑ Commercial Residential
Electrical contractor name' License number Date Expires
? o12i��s 2�� ��� Q� ❑New T1ltered/Addition
Purchaser's mailing address
y, e . 4-�I/'
City State ZIP
Telephone number FAX number_
5-lolr--/-4/Z
Premises owner's name
;0,3 e[512.7'
Address of inspection
Z/V Cs- Ic1f/i cog
city
/�
Phone number to schedule inspection:
Owner as defined by RCW19.28.261:(I) 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. ❑ Cash ❑ Check#
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 instal- ❑Credit Card Ursa Mastercard Discover
lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter
19.28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and Card#
----------------
Utility
_ - - -
Utility Specificati -------------
Signature o ectri contractor or electrical administratorjExpirationDate
Inspection fee
X Dater g-�lof card /p
Electric Load Additions and or subtractions Service Information
❑ NO LOAD CHANGES
❑ Baseboard _KW Voltage
❑ Furnace _KW ❑ Overhead Service Phase❑ 1 ❑ 3
❑ Heat Pump _Ton LAR ❑ Temp Service Service Size:
❑ Fan-Wall _KW ❑ Underground Service Feeder Size:
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-41.7-4735
ROUGH-IN THERMOSTAT SERVICE
Date Approved By Date Approved By Date Approved By
FINAL DITCH FEEDER
Date Approved By Date Approved By Date Approved By
Inspection Area,Buildingor Equipment Ins ected Electrical
Date Action Taken
Inspector
0°' CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
321 EAST 5TH STREET. PORT ANGELES.WA 98362
Application Number . . . . . 06-00000472' Date 5/12/06
Application pin number . . . 065232
Property Address . . 214 WHIDBY AVE
ASSESSOR PARCEL NUMBER: 06-30-10-5-0-0930-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
Owner Contractor
KENNEDY ROBERT A THORNES REFRIGERATION
214 WHIDBY AVE PO BOX 991
PORT ANGELES WA 983626542 PORT ANGELES WA 98362
(360) 461-0158
---------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc THORNES/ T-STAT WTR HT
Permit pin number 77115
Sub Contractor THORNES REFRIGERATION
Permit Fee . . . . 48.10 Plan Check Fee .00
Issue Date . . 5/11/06 Valuation . . . . 0
Expiration Date 11/07/06
Qty Unit Charge Per Extension
1.00 48.1000 ECH EL-R OR RM 1-4 ALT CIRCUITS 48.10
-----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 48.10 48.10 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 48.10 48.10 .00 .00
COMMENTS/ACTION NEEDED
RT
u+DY Po���cF�N CITY OF PORT ANGELES LIGHT DEPARTMENT
wr�1 321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411 PERMIT NO.
DATE
ELECTRICAL PERMIT '
Site Address: (, / ❑ READY FOR 11 WILL CALL FOR
c9// �Ip INSPECTION INSPECTION
Installed By: It License Number: Phone:
Owner/Business: I�( _ --fLPhone:
Owner/Business Address:/ {, _-` Sq. Ft.
ELECTRIC HEAT RESIDENTIAL ❑ RISER
❑ BASEBOARD KW ❑ COMMERCIAL ❑ OVERHEAD SERVICE
P FURNACE KW/,T ❑ NEW CONSTRUCTION ❑ UNDERGROUND SERVICE
95 HEAT PUMP KW ❑ REMODEL VOLTAGE:
❑ FAN/WALL KW '1�4 ADD/ALTER CIRCUITS ❑ 1 ❑ 3
11 SERVICE UPGRADE/REPAIR
SERVICE SIZE AMPS
❑ TEMPORARY SERVICE FEEDER SIZE AMPS
Details/Description:
i
W.S. No. SERVICE SIZE DATE ENGR.
CAPACITY:
❑ O.K. ❑ NOT O.K. ❑ OVERHEAD SERVICE APPROVED
ACTION REQUIRED: ❑ CHANGE TRANSFORMER ❑ CHANGE SERVICE WIRE
❑ INSTALL SERVICE POLE ❑ OTHER
❑ Ditch Inspection O.K.
❑ Rough-in/cover O.K.
❑ O.K. to connect service
Ael Final O.K.
I
Site Address: / //•• �/ Permit/Receipt No.
Installer: New Meters Date:
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.
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
1 $ /r
Electrical inspeclor Permit Fee
WHITE—File by address PINK—Top:Eng,Bottom,Customer GREEN—Top:Meter Dept.,Bottom:City Hall
OLYMPIC PRINTERS INC.
e
PORT 4
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362t, (206) 457-0411 PERMIT NO.
DATE 3AAz z
ELECTRICAL PERMIT
Site Address: /\ / C1READY FOR El WILL CALL FOR
O� A ,(j INSPECTION INSPECTION
Installed By: r License Number: Phone:
Owner/Business: G Phone:
Own�er/'Business Address: Sq. Ft.
� RESIDENTIAL ❑ TEMPORARY SERVICE ❑ OVERHEAD SERVICE
❑ COMMERCIAL ❑ PERMANENT SERVICE ❑ UNDERGROUND SERVICE
❑ BASEBOARD KW NEW CONSTRUCTION VOLTAGE:
El FURNACE KW REMODEL ❑ SINGLE PHASE
❑ FAN/WALL KW ADD/ALTER CIRCUITS ❑ THREE PHASE
❑ MEAT PUMP KW SERVICE UPGRADE/REPAIR SERVICE SIZE AMPS
❑ SIGN ❑ SPECIAL EQUIPMENT
(LIST BELOW)
Details/Description:
j
I
W.S. No. SERVICE SIZE DATE ENGR.
CAPACITY:
❑ O.K. NOT O.K.
ACTION REQUIRED: ❑ CHANGE TRANSFORMER ❑ CHANGE SERVICE WIRE
❑ INSTALL SERVICE POLE ❑ OTHER
❑ Ditch Inspection O.K.
/ Rough-in/cover O.K.
/❑ O.K. to connect service
❑ Final O.K.
I
Site Address: Permit/Re eipt No.
Installer: New Meters Date:
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 Buildm Permit. PHONE 457-0411, EXT. 224.
/ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT C•[/�D w
lectrical Inspector Permit Fee
WHITE—File by address YELLOW—file by number PINK—Top:Eng,Bottom,Customer GREEN—Top:Meter Dept.,Bottom:City Hall
OLYNP[C PRINTERS INC.
CITY OF PORT ANGELES
LIGHT DEPARTMENT ELECTRICAL PERMIT -N° 17081
cy
Port Angeles, Washington----------- >!
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 do electrical work as listed below.
Address ------------
Owner
Z _� ��-�j�-- ------ Occupancy
- -/� -------��..........................
Owner i�i,_n „ - ------- Tenant--------------------•-------------------------------••---•-••-------
^
Wiring Contractor ;F �... _ ter.:4 a. �"------------- By- _----------•-----------------------------------------•---------
Light Outlets..................................._..... Service, volts --,,1.- .� �`� Type of Wiring:
3 �....................
Receptacle Outlets............................... No. wires ............�..._j. .............-. Armored Cable ..............................
Dryer, KW-...............'—.....--- 1/e� Non-Metallic ............-------......_---
----------- Size wires......................�_......_..
Knob & Tube................................_
Range, KW........................................_ Main fuse .... ....�g.......:
Rigid Conduit ..........................._..
Water Heater: Enclosure ........_.5............................'
Metallic Tubing ......................._..
KW.--.................. . . . Type of wiring: Raceway
Heat: RW.... .. Entrance Cable -----------------------------
G. ,.le........ Circuits, Light..................................._..
Motors: size, volt and phase: Rigid Conduit ------------------------------- Utility .............................................
........................................................... Metallic Tubing ........................... Heat ......................................._..Y.
Current transformers: Range .............................................
...............................__.........................
No. & Size....................................... Water Heater ...............................
...........................................................
Ser. No............................................... Motor ............................................
Ser. No..................:. ......... Dryer..............................................__
................. Furnace.............................................
Ser. No..............................................
TotalLoad.........------------------- Ser. No........... — .................... Total ............------.._...---------------
Remarks: ---- ?L t�.y rr ri{_:.1.....l.: X
----•-------------•-------------------------------- -•------------------------------------------ --------- ------------------- -------•--------...---•--------------••-----
------------------ -------------------- ------------------_----........ ---------------------------------------------------------------------------------------------------
Permit Fee Treas. Receipt
NOTIC1rCurrent 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° 17081
Address ........................................................................................................................................ Date......................:......._......_......_.........
Owner .........................................._.._............._.._........................................................... Tenant...................................................................
1.—Wiring Contractor..........................................................._............................................................. By..............................................................
NOTICE—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.
— IM Olympic Printers, Inc.