HomeMy WebLinkAbout2139 Airport Rd - Building
l~<"
~i;
"'-= """'
-.'"
ELECTRICAL PERMIT APPLICATION
roOR OPnC1At lIS'E ONl Y
D~I~Ill:(~':
l'(rml,l:
DI't'Arrm>cd:
O>-lcl~w..d:
\1
The Electrical Permit Appfic3tiorl must be filled out c:omDletefv.
\
Pll;!:ase type or fl~prinf In Ink. If you have any Quesllons. please call (360. 4' 7-.4735
Fax number: (360) 417-4711
CJ:3 - /0;2/
REaUEST INSPECTION 0
Address:
OwnerorElec.Conlrc1clorAgent hNGF..r.r-:s ET.R("TRTC: TNC P~one:452-Q7fi.4
propenyowtler:--POf\1( of '22"r ~t eJe...<;, .
333 c....v <2.."!>1- 'PI nr ._City "'i{A,
I\NGF.LE1460RS
license II: Exp:
Fa.: 4 'i'-<l7/,; '1
Phone:
EteClrical Contractor;
ANGELES ELECTRIC INC.
Zip: C:;)?.3 G ')..
Address: 524 EAST FIRST
Phone: 4'i7_<l7/,;4
INSTALLATION WIRED BY:
f] OWNER
Clly: PORT ANGELES. WA
x\t'LECTRICAL CONTRACTOR
Zip: 98362
Credit Card Holder Name:
Tpfl ~impc::nn
Billing Address:
City:
Credit C8rd Number:
EXp. Date:
ZIp:
VlSA:_MC:_
PROJECT ADDRESS:
/~o - df3cr
{) It (:012,
!loAy)
TYPE OF WORK:
Check all thai apply: ~ew
o AlleralionlAddition
o Residental 0 Mulli-family
~. Commercial . 0 MobileHome
Sq.Ft.
o Remote Meier 0 Detached garage [l Hot Tub 0 Swim Pool 0 Septic Pump [l Low Vollage 0 Telecom. 0 Sign
Number of CircuilS added or allered:
DESCRIPTION OF THE ELECTRICAL PROJECT:
!l'::/'+-'i'7~
A ~r \;Jor! ~+r8-n{""t<'
Qo2d t...u f]~
Eleclrical Heal load Addilions
Service Information
[J Baseboard
[J Furnace
[] Heat Pump
LJ Fan.Wall
_KW
_KW
_KW
_KW
o Overhead Service
o Temp Service
U Underground Service
Voltage: j ),0/ ':<'ItJ
Phase: IB1' '0 3
Service Size: .1.00
Feeder Size:
PAMC 14.05.060(8): F;r industrial. commercial. & residenlial projecls larger Ihan a duplex. a one _ line drawing of the Electrical Service &
Feeders. building size (sq. ft.), load calc'Jlalions, and Ihe fype & of conductors and/or raceway Is required and shall accompany the
Electrical Permit applicafion,
I hereby certify fhat 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 il is not the Ciry's legal responsibility to determine what permits
are required; it remains the applicants responsibility to determine what permits are required and to obtain such.
'W-90l9
CredItCardfJOlder'SSignature:~'1 1'_ ,!:~ru .~Dale: '7/;).~/o.3
Owner or EJ"c. ConI. Signature: Date:
--{j?{})JSf*:Jl1l1 C:IZ- IN 5TIJf.L5P
(9-~ Jt~ . to/to (op
'2tt C; cP~ ~ 03 59(;6 (;517
ws
"165':1
wP!i5'i>O .
. .\Jt-
.~.
09E :IN I :J I ::U:J:3T3 S:3"l:38N\1 I"O::JcJ
f ?6.3D
H\1(;(;'L E0(;-17(;-L