HomeMy WebLinkAbout543 Whidby Ave - Building
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CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL P'ERMIT
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FEE RE ::EIPT NUMBER
PERMIT NUMBER
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TC "AL FEE /6 66 j(EJ
-- CONT. Lie. NO. TIME TO COMPLETE NO. STORIES LEGAL OCCUPANCY
Site Add' ~ss
Owner _ f'JI fl. S ,
Owner's \ddress
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
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GORREyT ADD~SS IS RESPON IBJLJTY OF APPLICANT
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PERMITS WITH WRONG ~EhES ARE CAfj.CELL~
Installation By ..) !;E(IC I C-
Installers Address
Day Pho e Installers Phone
Applicat )n;s hereby made for Permit to install Electrical Equipment as follows:
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Wiring Method
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AMP 240V NUMBER AMP 120V 240V
USE OF CIRCUIT NUMBER PER t20V 100R FEE USE OF CIRCUIT PER 100A FEE
CIRCUITS CIR 10 30 CIRCUITS CIR 10 30
LIGHT SIGN
LIGHT 50 VOLTS
OR LESS
CONvENIENCE MOTOR
CONVENIENCE MOTOR
APPLI,6 NCE MOTOR
DISHW o\SHER FIRE ALARMS
D1SPQ AL \,1.\ BURGLAR ALARM
RANG: I i.// MISC,
OVEN I I,
- ~ ~~ 9 ~ V-
WATE: HEATER
-
LAUN[ RY
-
DRYEF REINSTALLATION LIGHT FIXTURE #
~'~E SUB TOTAL FEE
GAS- llL
~. ~E ENERGY FEE
~~IC BASIC FEE
ELEC1 ~IC HEAT
- TOTAL FEE
ELEC1 ~IC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
-
A.C. U :IT AMP PHASE
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FEEDE ~ SIZE OF SERVICE ENTRANCE CONDUCTORS
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SERVI( .E A.W.G.
- I SUB-TOTAL
SIZE OF GROUND SIZE OF ENTRANCE SWITCH
Date A: plication made
is permit will be done by the installer and in conformance with the N.E.C. Electrical Code.
,19
By
CONTRACTOR OR OWNER (OR AUTHORIZED AGENT)
Pe mission is hereby given to do the above described work, according to the conditions hereon and according to the approved plans and
specifi: ations pertaining thereto, subject to compliance with the Ordinances of t e City of Port Angele
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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 _
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Date p. rmit Issued
I WA RNING I
WHITE. Original CANARY - Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
OLYMPI PRINTERS, INC.
REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
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O.K. FOR COVERING
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O.K. TO CONNECT SERVICE -
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CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 15865
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Port Angeles, Washlngtonmm____.:t______________________mm_m_mm__mm__, 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-
nllE sion is hereby granted to do electrical work as listed below_
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~::::s__:::::::::J.:~;;l:::::c~:&:q::::::::::::::::::----;~:~:~:::__~:::~~_~:~:::~::::::::::::::::::::::::::::::::::
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Wil ing Contractor ____""""_<t,!''"'"''-C2_d.."_mmm_m_________m_________m By..____._.______________________mm____.____________.____m_m__._
Lig It Outlets..............~.......__.____... Service, volts ....j..:?:..6.,/...?.r.o....... Type of Wiring:
Re'eptacle Outlets v 0 "0 wires Armored Cable .._..........00.00_...........
" __..n..t:l............n....... l' . .......:~~........__.".'...__.nn
D,y' '. KW....----f;:,..-----.................... Size wires..;Jf'-;~.&.:../~,y.
Ran, e, KW .__........~.........u_____ 1\faln fuse ...............h....m...nn__mn.
S
Enclosure mnm__n.n__.mm_...,m___.___
Non-Metalllc ................................_ /'
Knob & Tube................................~. /
1/
Rigid Conduit .._........................:..
Wa er Heater:
KW....../t..5...X':2...............
He,' Kw......d.1:....!f1;r..!3.8
Metallic Tubing hnh...mh_............
Type of wIring:
Entrance Cable ......___"..____
Ser, NO..n.n.h.......n_.._.....nn..._nn......
Raceway ___.__n.._..__..._..........._.._....._
CircuIts, Light..I.2............................
Utility./.9....................................
Heat .,/~............................._......
:J
Range ....'h_.h..h...............................
d
Water Heater n_:___m..n_n____m.___._.
:::::...~~~~~~~~~~~~~~-.~~~~~~~~~~~~~~~~~~~..~~~'
Mot )rs: siz,e, volts and phase:
...Ltg!:.:':-:12..................._......._......
.....;.12-(-,~:........-..........................
RIgid Conduit ._____mm
Metalllc Tubing un___.
Current transformerlJ:
No. & Size_n___n....n.........................
Ser. No. n.__.nnnn__.........___.................
;<-
'YG /'
Total lAladnnuu..................... Ser. No. ..00_0000..000000_...0000.0000.00............ Total .............._n........-!"..........n_..
ReI larks: ____..._______,.,g.R_,{_"-!=:,__CA?k~!........_..____m__________...__.........m..._...____..___..m_____m...__...___..._..__.._
Ser. NO..n....__..._n......................__...__n
Furnace ________._..._...._......'_..................
.-.....-.---.-..-.~~.-~~_._._....__.__._____.._._....._______.__..____.....~....~._~.__...___#._................._.__.____.__._____..~~.........._____.._.......__........n.
m___ m----------...-----------m------...--..m-----'--"---------.....m.......----------------..."..:-.....';Z;-.........___.u..,:mm__...m____......._____
:~~~~_~~~_____,,__________ ::~_~_~:__~_~_~_~~_~_~________ By .;{.,~__;K{J-:fI(:.~i;~~I-L/.:-..
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con.
cealed due noUce 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?
15865
Add ess
Date.______.n____.._.._.........._.....__.__._.____......
OWl: ~r _n__...............__nnn.........n.......__......_......_.._........_......................nn..n__nn.nn......... Tenant_nn.............nnnnn_..n.__...............nn__n_nn....
Wir; 19 Contractor......_...___.________...............__.............__....._..............._......_...._________.__................_.___. By._...._.._____.._._____.____..._.__................_.....__.._
\fOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con.
ceal d due notice must be given the Inspector so that work may be inspected before concealment.
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