HomeMy WebLinkAbout119 W 3rd St - Building
ELECTRICAL PERMIT APPLICATION
FOR OFFICIAL USE ONLY
DaleIRec:
Permit":
Date 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) 417-4735
Fax number: (360) 417-4711
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Property Owner.
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Phone:
REQUEST INSPECTION 0
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Owner or Elee. Contractor Agent:
Phone:
Electrical Contractor.
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Zip: 9&J6:J".
Address:
License #:
Exp: Phone:
Address:
INSTALLATION WIRED BY:
DOWNER
City:
0tlECTRICAl CONTRACTOR
Zip:
Credit Card Holder Name:
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City:
Billing Address:
Credit Card Number:
Exp. Date:
Zip:
VISA: MC:
PROJECT ADDRESS:
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TYPE OF WORK:
Check all that apply: 0 New
d'Alteration/Addition
1ZI Residental 0 Multi-family
o Commercial 0 Mobile Home
Sq. Ft
Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump
o Low Voltage 0 Telecom. 0 Sil
Number of Circuits added or altered:
DESCRIPTION OF THE ELECTRICAL PROJECT:
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,,' Electrical Heat Load Additions
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PERMIT FEE: (,5, ;;60
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Service Information
o Baseboard
o Furnace
o Heat Pump
o Fan-Wall
KW
KW
_TON
KW
LRA
o Overhead Service
o Temp Service
o Underground Service
Voltage:
Phase: 0 1 0 3
Service Size:
Feeder Size:
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 Electrica
Permit application.
I hereby certify that I have read and examined this application and know that same to be true and correct, and I an
authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits a~
required; it remains the applicants responsibility to determine what permits are required and to obtain such.
'Credit Card Holder's Signature:
Date:
Owner or Elec. Cont. Signature:
C:/ELECTRICALPERMIT APPLICATION
Date: