HomeMy WebLinkAbout113 E 3rd St - Building
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ELECTRICAL PERMIT APPLICATION
FOR OFFICIAL !L~N.l.Y-c3
DateIRec: I I
Pcnnit#: 7 q L
Datc:Approved:
Date Issued:
The Electrical Permit Application must be filled out comDletelv.
Please type or reprint in ink. If you have any questions, please call (360) 417-\735
Fax number: (360) 417-4711
REQUEST INSPECTION 0
Owner or Elee. Contractor Agent:
Phone:
Fax:
Property Owner. MAR Y ANIII 8dlEEAl
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Address: Po B,I'X t; lfr2-3 City:
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Electrical Contractor: /'IlJtYtJHSEA/S IELEc.77?/t.
Address: /42/n' W /t / Ii
PORi Ll(OLilW'
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Exp:
Phonegt;a ~43?-.93B/i,
Zip: /tA.9~ E
2h3'/tJf Phone:f5~-7.11'l1:i
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City: pntr ANGElC'S
INSTALLATION WIRED BY:
DOWNER
lX\'LECTRICAL CONTRACTOR
Credit Card Holder Name: IIALVtJR5"I!'N.s liLEC'TRJiP
Billing Address: /42../. W i/ Ii City: PI'!PT AN(;FLP-S
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Credit Card Number: - Exp. Date: .:!!-!
Zip: 9t:13{,,<j
VISA:'/ MC:_
PROJECT ADDRESS:
//3 E' :3'RD
TYPE OF WORK:
Check all that apply: 0 New
Jl'l.Alteration/Addition
o Residental 0 Multi-family
9\ Commercial 0 Mobile Home
Sq. Ft
Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump
Number of Circuits added or altered: 4
o Low Voltage 0 Telecom. 0 Si~
DESCRIPTION OF THE ELECTRICAL PROJECT:
RFMoD/?'L OPACEi SP13-CE
PERMITFEE!S;-1, ~O
Service Information
1.-- (0 TP>o
Electrical Heat Load Additions
Jt!jIf.
o Baseboard KW
o Furnace KW
o Heat Pump TON
o Fan-Wall - KW
VV I'f 'J1?R. 1/ f)1}ptllf. 5 f( W
PAMC 14.05.060(B): For industrial, commercial. & residential projects larger than a duplex. a one - line drawing of the Electrical Service &
Feeders, building size (sq. ft.), load calculations, and the type &of conductors and/or raceway is required and shall accompany the Electrical
Permit application.
LRA
o Overhead Service
o Temp Service
o Underground Service
Voltage:
Phase: 0 1
Service Size:
Feeder Size:
03
I hereby certify that I have read and examined this application and know that 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 determine what permits an
s responsibility t permits are required and to obtain such.
,/z'1Io.it- o~ A:? 1-:$ ~J...l ~ /C.ltt.!) <;4 ~~s~~ rUf:PJ
Credit Card Holder's Signature: ~ 44Il #~~ Date: 1/21//)"1
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Owner or Elec. Cont. Signature: r'-""~ 41f .d"Y:::;;L/>~ Date: 1/"'1/0'1
C:/ELECTRICALPERMIT APPLICATION
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