HomeMy WebLinkAbout1118 E 7th St - Building
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ELECTRICAL PERMIT APPLICATION
FOR Of'FlCIAL USE ONLY
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Pmnit tr:
Dale Appnt\led:
D;ueluurd:
The Electrical Pennit 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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Owner or Elec. Contractor Agent: t'VV1l a,~ a-..J
M~ -44 Co...v.----
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Phone: '-f I 7-0 <-)G5 Fax:
Property Owner:
Address: II I '1
Phone:
41 7 oc;~5
Zip: <7j€, '5 .(.:L
City:
(c,.r-+- A-~r<" s
Electrical Contractor:
license #:
Exp:
Phone:
INSTALLATION WIRED BY:
t9-6WNER
City:
o ELECTRICAL CONTRACTOR
Zip:
Address:
Credit Card Holder Name:
Credit Card Number:
Exp. Date:
Zip:
VISA:_MC:
BII/ing Address:
City:
PROJECT ADDRESS:
~ll,,", CI 1~)-/-.
TYPE OF WORK:
Check all that apply: !9-New
o A~erationlAddition
~idental 0 Multi-family
o Commercial 0 Mobile Home
Sq. Ft.
.f,
o Remote Meter' 0 Detached garage 0 Hot Tub 0 SwimJ'ool 0 Septic Pump 0 Low Voltage 0 Telecom.. 0:
Number of Circuits added or altered: .' ....
DESCRIPTION OF THE'ELECTRicAL PROJECT: .,)....-.-> '?;to a...~ <!.e..--v L'u::.... ~ ~-Ie ....
~~ ~ +0 r..e.c.-J b v : I c;{ ~ ~ ~ c{e>....bl-e. 0.1 eL/' L~ "'-'\A ~ 1'" -f= "-OJ ,;: "-
Electrical Heat Load Additions
Service Information
o Baseboard
o Furnace
o Heat Pump
man-Wail
_ 'rWV
_'rWV
_KW
_ 'rWV
;aoverhead Service
o Temp Service
o Underground Service
Voltage: IZO/'/:.'IO
Phase: l"ll' 0 3
Service Size: ~;?>>
Feeder Size: 2.=
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 andlor raceway is required and shall accompany the
Electrical Permit application.
I hereby certify that I have read and examined this application and know that same to be true and correct. and I
authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits
are required; it remains the applicants responsibility to determine what permits are required and to obtain such.
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Credit Card Holder's Signature: '-" / Date: ~
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