HomeMy WebLinkAbout514 G St - BuildingOWNCR
?Vt- S1 PRo_fZ.
CONTRACTOR
ADDRESS
5 1 4
Ti a MPx..rz_ i sr14u, r
ELECTRICAL INSPECTION
WIRING REPORT
417 -4735
DATE' 1 I I 1 I PERMIT INSPECTOR
APPROVED NOT APPROVED
DITCH
ROUGH IN /COVER 1
SERVICE
FINAL
CORRECTIONS NEEDED: Cs et) tiN 5) awl S 41V t 24E.. A rem
Scl6 P,ar.I EL n) ife;c Z-SO 6 3Z. R
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NS
O I I ECTOR WHR I S
ARE COMPLETED WITHIN 15 DAYS
DO NOT REMOVE
Application Number 11 00000048
Application pin number 932256
Property Address 514 G ST
ASSESSOR PARCEL NUMBER 06 30 00 0 1 2175 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
New panel and 5 circuits
Owner Contractor
RAYMOND 0 VENESSA PULSIPHER OWNER
PO BOX 1572
PORT ANGELES WA 98362
(360) 775 5054
ELECTRICAL PERMIT
CIT' OF PORT ANGELES
360- 417 -4735
Date 1/13/11
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit pin number 180380
Permit Fee 132 90 Plan Check Fee 00
Issue Date 1/13/11 Valuation 0
Expiration Date 7/12/11
Qty Unit Charge Per Extension
5 00 2 6000 ECH EL BRANCH CIRCUIT W /FEEDER 13 00
1 00 119 9000 ECH EL 0 200 SRV FEEDER 119 90
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FIN AL
COMMENTS
Sienature of owner or Electrical Contractor
Charged Paid Credited
132 90 132 90 00
00 00 00
132 90 132 90 00
PERMIT WILL EXPIRE SIN (G) MONTHS FROM LAST INSPECTION
Due
DATE RESULTS
00
00
00
INSPECTOR.
421 /Pi P 1 4 Ai
3
Oh 11
Date
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Signature of owner, electrical contractor or electrical administrator
Dated:
RECEIVE
CITY OF PORT ANGELES PERMIT APPLICATION ►JAN 13 2011
Building Division/Electrical Inspections ELECTRICAL
321 East Fifth Street P 0 Box 1150 Port Angeles Washington, 98362 INSPECTIONS
Ph (360) 417 -4735 Fax: (360) 417 -4711 r
Date.
1 2 Single Family Dwelling Multi Family or Commercial* Commercial Addition Alteration Remodel Repair*
*Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 5/4/ 5 S fref.4r For+ A. 1/2r S S36 3
Building Square Footage: c3S 0
Description of above +.t ICS TA. r -1 tc. c- s-1 v S c v c urr'S
Owner I Contractor Information
Name: 1 D,,A Vin k )\.L_r Name:
Mailin Address:' S (am. 3 f Mailing Address:
City /-'4- nae(g State: Wp Zip: 9f331b3 City State: i /tip:
Phone: 31,0 02 4$19 Fax: Phone: Fax:
License /Exp. License Exp.
Y
Item Unit Charge Total (Qtv Multiplied by Unit Charge)
Service/Feeder 200 Amp. 119.90 1 1/ 9 yU
Service /Feeder 201 -400 Amp. 145.50
Service /Feeder 401 -600 Amp 204.60
Service /Feeder 601 1000 Amp. 262.20
Service /Feeder over 1000 Amp. 372.50
Branch Circuit W/ Service Feeder 2.60 0 3 °(.7--
Branch Circuit W/O Service Feeder 73.50
Each Additional Branch Circuit 2.60
Temp. Service/ Feeder 200 Amp. 92.70
Temp. Service /Feeder 201 -400 Amp. 110.30
Temp. Service /Feeder 401 -600 Amp. 148.70
Temp. Service /Feeder 601 1000 Amp 167.90
Portal to Portal: Hourly 95.90
Sign /Outline Lighting 88.20
Signal Circuit/ Limited Energy First 1500 sf Commercial 95.90
Note $5.00 for each additional 1500 sf
Signal Circuit/ Limited Energy 1 2 Family Dwelling 63.90
Signal Circuit/.Limited Energy Multi Family Dwelling 63.90
Manufactured Home Connection 119.90
Renewable Electrical Energy 5KVA System or Less 102.30
Thermostat 56.00
NEW CONSTRUCTION ONLY.
First 1300 Square Ft. 110.30
Each Additional 500 Square Ft. or Portion of 35.20
Each Outbuilding or Detached Garage 73.50
Each Swimming Pool or Hot Tub 110.30
/3T °1 Total
Owner as defined by RCW 19.28.261 (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required
to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection.
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor I am making
the electrical installation or alteration in compliance with the electrical laws, N.E.0 RCW Chapter 19.28, WAC Chapter 296 -46B, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14 05 050 regarding Electrical Permit Applications.
Cash Check
Credit Card
01/0112010
sf 11M111
i>
moor
OWNER/CONTRACTOR
ELECTRICAL INSPECTION
WIRING REPORT
417 -4735
DATS PERMIT INSPECTOR
1 c 1 1 I til
A hL17 PQL,Si Tsvr rats, CL ILe-
ADDRESS
APPROVED NOT APPROVED
DITCH
ROUGH IN /COVER
0. SERVICE
FINAL
CORRECTIONS NEEDED: A I-(J 'Q p &c.C.l 21CL
iAzf1 -k F21 012 -It �►t L
gv c L Di (c P aPprR'6".r. rs.kl."3' pitic)OV
Fol►,f, u./L, rr •n1T
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
DO NOT REMOVE
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
5 circuits for outbuilding
Owner
RAYMOND 0 AND VENESSA PULSIPHE
PO BOX 1572
PORT ANGELES WA 98362
Fee summar'
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE 1 DATE.
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X
G \EXCHANGE \BUILDING
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -4735
11 00000020
500880
514 G ST
06 30 00 0 1 2175 0000
ELECTRICAL ONLY
RS7 RESDNTL SINGLE FAMILY
0
Contractor
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit pin number 179994
Permit Fee 83 90 Plan Check Fee
Issue Date 1/05/11 Valuation
Expiration Date 7/04/11
Qty Unit Charge Per
1 00 73 5000 ECH EL BRANCH CIRCUIT WO /FEEDER
4 00 2 6000 ECH EL ECH ADDNT BRANCH CIRCUIT
Charged Paid Credited
83 90 83 90 00
00 00 00
83 90 83 90 00
Iv,- 1 b L
1� 1zl
Date 1/05/11
EXTRA MILE TECH ELECT LLC
418 N RACE ST
PORT ANGELES
(360) 457 0198
WA 98362
A5, 566c
RESULTS
Extension
73 50
10 40
Due
00
00
00
00
0
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTOR.
4,1>
Date:
ly s! Port Angeles Permit Application
;I.l,lding !)ivisronkilecuical Inspections
1 L FUIh 0Iroal P.O. (lox 1 ISO
>lar qnr 9 Washinrtan 98362
1
rah 1360) 417.4135 Far: 360) 417.4111
5ingle amvy •weihn(;
w.),Iy G r■rmlelCIar
i1 me nt 1 Arcrabgn Rorirn)
lie kequiiet Please (Icm.ricti, f: r- !Rear Plan Review Information Sheet
itches --5 3 9.
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'Li ,el as Miner; by RCVS/ 19.26.201, (11 Owner Niil occupy Ito slructUra for two years after lhle electrical permit 15 flniNrerl. (y) 1,wrwwr Is Iequlred r0 tarn an electrical contra-to/
gab we id properly 15 for sJIC, rent or lease, Permit Aspires eller six months of fast inspection.
1 1 I III I d ��Q III•• yr a licensed etectrIcel conlrac(or. 1 !A1 1111k1110 1110 011[l(IC+II IOSIOIbf100 YI
1 1 i
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/i I11 d l l A e
ailar311on i; ;um?Ilanr;e wilh the electrical. la NS N,( C RCW, Chapter 19i8, W C. Chapter ter296 X69, IS/ o
.luatur clevreer elect, C1lcontractor orcie meat Idlnlnlslretut
LI ir.
fl
C9ntractor Inforration
Name: EXf/L' M TiQl(r.�'(_
Mailing Address:
s G n City: P Slate' W tar Zip `J5 L
Phone: Y 7 -S.Ual Fao: .t.(14:jj a Err
License 1 Exp, aric$f tt ef C 71011
d I
i olal a 3,U I 0 OL IV -nl Iar4
Service/Feeder 200 Amp
ServicelFeeder 201 400 Amp.
Service/Feeder 401 AMP.
ServicelFeeder 601 -1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W! Service Feeder
Z3, co Branch Circuit W10 Service Feeder
0 r(a_ Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp.
Temp. ServicelFeeder 201400 Amp.
Temp ServicelFeeder 401 600 Amp
Temp. See/ice/Feeder 601.1000 Amp
Portal to Portal Hourly Siga!Oupine Lighting
Signet Circuit/ Limited Energy Commercial Adellinnar /15 10
Signal C'ncwV Limited Energy 1 8 2 Femiy Dwelling
Signal Devil/ limited Energy Muld•Femily Owellmg
Manulactured Home Connection
Renewable Electrical Energy 5KVA System or Lest
First 1300 Square Ft
w_.._ Each Additional 500 Square Ft, or Portion of
t
Each Outbuilding or Detached Garage
Each Swimming Pool or 1.lot Tub
Thennoslal
!tO To191
r r.
i le
RECEIVED
JAN 2011 g
ELECTRICAL JJ
INSPECTIONS
0 Credit Caro tI
I
C C
PREPARED 10/05/06 11 16 37 INSPECTION TICKET PAGE 8
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 10/05/06
ADDRESS 514 G ST SUBDIV
TENANT NBR RAY PULSIPHER
CONTRACTOR ANGELES CONSTRUCTION PHONE (360) 460 6508
OWNER RAY PULSIPHER PHONE (360) 417 6844
PARCEL 06 30 00 0 1 2175 0000
APPL NUMBER 06 00000370 RE ROOF
PERMIT BNOP 00 BUILDING PERMIT NO PR FEE
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL99 01 10
kL0
BUILDING FINAL TIME 13 00
RAY 417 6844
10/04/2006 04 52 PM DYASUMUR
COMMENTS AND NOTES
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
RAY PULSIPHER
514 S G ST
PORT ANGELES
(360) 417 6844
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
WA 983620334
T-\Policies \1102 15 building pennitinspection record05.wpd [1/4/20051
06 00000370
359240
514 G ST
06 30 00 0 1 2175 0000
RAY PULSIPHER
RE ROOF
RS7 RESDNTL SINGLE FAMILY
1624
Contractor
ANGELES CONSTRUCTION
2542 JAKES RD
PORT ANGELES
(360) 460 6508
Permit BUILDING PERMIT NO PR FEE
Additional desc TEAR -OFF FELT COMP
Permit pin number 75143
Permit Fee 86 60 Plan Check Fee 00
Issue Date Valuation 1624
Expiration Date 10/18/06
Qty Unit Charge Per Extension
BASE FEE 50 00
12 00 3 0500 HND BL -501 2K (3 05 PER C) 36 60
Other Fees STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 86 60 86 60 00 00 J
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 91 10 91 10 00 00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
fora period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
2/
Signature Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
Date 4/21/06
WA 98636
Ri\i MW
ials/t0C,
CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS.
CALL 417 -4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES 1 NO
FOUNDATION:
FOOTINGS
SHEAR WALLS WALLS
RESIDENTIAL
ELECTRICAL LIGHT DEPT
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
HEAT PUMP FURNACE /DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
COMMERCIAL HOOD DUCTS
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING/LIGHTING
LANDSCAPING
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
FIRE 417 -4653
PLANNING DEPT 417 -4750
BUILDING 417 -4815
T \Policies \1102_15 building permit inspection record05 wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
1 1
1 I
I I
1 I
1 1 1
1 1 I
1 1
1 1 I
1 1 1
1 1 1
1 I 1
I I
1 1
1 1 1
1 1 1
I I
1 1 1
1 1
1 1 1
1 1
1 1 1
1 1 1
FINAL
FINAL
SEPA.
ESA.
SHORELINE.
DATE ACCEPTED BY.
DATE ACCEPTED BY.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES 1 NO
417 -4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW ENGINEERING
1 FIRE DEPT 1
1 PLANNING DEPT 1
1 BUILDING 1
av5 /t(./ fv,/) 14/ -e 00 4
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Sbo od
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(5
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11-194_ 2( off,
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DMSION
321 EAST 5TH STREET, PORT ANGELF~, WA 98362
BUILDING PERMIT ISSUED: 3/21/2000 PERMIT NO: 11824
OWNER/APPLICANT PROPERTY LOCATION
514 GSTS
CYNTHIA WARNE
514 S. G ST Lot: N.50' OF LOTS 19&20
Pod Angeles, WA 98362 Block: 121 [] Long Legal
360/457-1477 Subdivision: TPA
T: S: Parcel No:
CONTRACTOR ARCHITECT
OWNER N/A
VARIOUS
Port Angeles, WA 99360 , 98360-0000
206/000-0000 360/000-0000
PROJECT INFO
Project Value: $500.00 SFD Units: 0 Commercial: 0
Project Type: SFR ADD/REMODEL SFD SQ FT: 0 Industrial: 0
Occupancy Type: Garage: 0
Occupancy Group: MFD Units: 0
Construction Type: MFD SQ FT: 0
Zoning Use: RS7
PROJECT NOTES
10'X 12' BATHROOM ADDITION
FEES ASSESSMENT
Building Permit: $23.50 Misc Fee 1: $0.00
Plan Check: $0.00 Misc Fee 2: $0.00
State Surcharge: $4.50 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $0.00 TOTAL FEE: $28.00
Plumbing: $0.00 AMOUNT PAID: $28.00
Mechanical: $0.00 BALANCE DUE: $0.00
Radon: $0.00
RW SANITARY WATER DWY STORM DRA OTHER
Separate Permits are required for electrical work, utilities, private and public improvements. This permit becomes null and void if work or
constmc~en autho~zed is not commenced within 180 days, if constru~on or work is suspended or abandoned for a pedod of 180 days after
the work es commenced, or if required ir4pec~ons have not been requested within 180 days from the last inspection. I hereby ceCJfy that I have
read and e~amined this applca~on and know the same to be ~ue and con'ecL All provisions of ~ and ordinances governing this type of work
will be complied with whether specified herein or not The granting of a permi~ does not presume to give authority to vielate or cancel the
~rovisions of any state or local law regulating construction or the pen'ormance~of construction.
Signature of Contractor or Authorized A~ent Date §i~lnat~re bf Owner (it owner is builder) DateTM
BUILDING PERMIT INSPECTION RECORD
CALL 417-A81 $ FOR BUg_DInG I~$P]ECTIOI~/$. PLEASE PI~.OVIDE A IvtlI~/IMUM 2~ HOUP. N'OTICE.
I.N$~L,~ T~ 01~ ¢03!¢F~£ ~ ~,?01~ B£1FOI~ IArSP~Cl~D AND A ¢~'E, PTF~. PO~T PgRMII I~ A COI~ISPICIJOU8 LO~T1ON.
KF~P PERMi'r CARD ~ APPROVED PLAlq$ AT JOB SITE
o~ ~onr ~ FOR OFFICIAL USE ONLY:
°~ BUILDING PERMIT - PREAPPLICATION
Permit #:
The Building Permit - Preapplication must be filled out completely. Date Approved:
Please type or print in ink. If you have any questions, please call 417-4815
Applicant and/or Agent: Phone:
~Owner: (~/b~o (/~tg,/LI/x-~ Phone:
Address:ff~ '/~{iO ~'~d City: ~3fq ~el~S Zip:~O~
~cNtect~n~neer: ~U~ Phone:
Contractor ~ License ~: Exp: Phone:
Address: City:. Zip:
PROJECT ADD.SS:
~GAL DESC~ON: ~t: t% ~ ~ Bl~k: { ~
T~Y~eE OF WOR_I~ SIZE/VALUATION:
sidential l~xNewCons~r. [] Reroof [] Woodstove I'g.c~ '"'-SF.@$ /SF.=$
ulti-family ~1 Addition [] Move [] Garage SF. ~ $ /SF. = $
rl Commercial ~Remodel [] Demolition 13 Deck SF. ~ $ /SF. = $
[] Repair rn Sign [] TOTAL VALUATION $.
BRIEF DESCRIFI'ION OF THE PROJECT:
COMMERCIAIJRESIDENTIAL: Occupancy_Group: /~P ~ occupant Load: ! C~ Construction Type:
No. of St0ries: / LotSize: ~O~'o 7' % Lot Coverage: -~-'7~<'~ %
Existing Lot Coverage: {~5-(,:, /sq. ft. + Proposed Lot Coverage: [TEe /sq. ft. = TOTAL LOT COVERAGE: t~7(t> /sq.R
PLANNING USE ONLY: APPROVALS: PLAN
,lqotes: BI3I)G
DPW
FIRE
ESA/Wetland(s): D Yes 13 No SEPA Checklist required? 13 Yes [] No Other: OTHER
PREAPPLICATION SI[IBMI'ITAL: Your applica~on and siteplan must befdled out eompl~l), to be accepted for review. The Building
Division can provide you with more detailed information on the application and plan submittal requirements.
BUILDING PERMIT APPLICATION SUBMi'ITAL: Your completed application, site plan (for additions) and building construction
.plans are to be submitted to the Building Division.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and
may be revised by the Building Div. to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: Your plan check fee is due at the time the building permit application and construction plans are submitted. All other
permit fees are due at the time o£permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, this application will expire by
limitations. The Building Official can extend the lime for action by the applicant up to 180 days, on written request by the applicant (see Section
304(d) of the Uniform Building Code, current edition). No application can be extended more than once
I hereby certij~ that I have read and examined this application and know the same to be true and correct, and I am authorized to apply for
this permit. I understand it is not the City's legal ~vsponsibi]ity to determine what permits are required; it remains the applicant's
what permits are required and to obtain sttch.
responsibility to determine ~ ~ '
PW-1102 13[rcv 2/96]
CI,TY OF PORT ANGELES
:LIGHT DEPARTMENT
ELECTRICAL PERMIT
N~
17660
Port Angeles, washlngton___IDn__'n.~.~____________________.._________' 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-
mission Is hereby granted to do electrical work as listed below.
Address S-:---lf-~-------%-----...~~t---:.n----.--n------.---nn--------- occupancyn.11P:4,_n1-..____~~!:.".r
~::grE:::~~~I(~.=:~:11:-::C~~~r::::::no.~~:~~~;:::::::::::::...~.._._~~:::::::::=::::::::::::::::::=:::::::::::::::::::
. .
Light Outl.IB............___...........................
Receptacle Outlets..............__..n____.......
Dryer, KW uuu..n.......__.___________________.__
Rimge, KW._._._..____........_.._....__
Water Heater:
KW.........no.........o....o....... "0.
Heat: KW...._nn_.nn.......__..n..............n
Motors: size, volts and phase:
Total Load_mnm.....n____._.......
Service, vo1ts~, -.;....:_::;.;.;:.:.;;:.::;._..;......h.....
,'.\iI:I.~t,,~ .
No. wire~*"&;d.;;.:.:.~:::.............
/ /f/tY .4 ...:...
Size wires..........:........_..._:..__....___.
,
Main fu8etl....r/_:1_m_y.m.n~-:;.::
Enclosure ....__..n....____mn___
Type of wiring:
Entrance Cable ___00.......
Rigid Conduit ___.___._________........___...
Metallic Tubing .m_mn..__m..........
Current transformers:
No. & Size........nn.........n......._......_.
Ser. NO._......_....n_._.._........___.n............
Ser. NO.nn......................__.........._.__...
Ser. NO..n_n......_............._._........_........
Ser. NO.._.....n...n_.._...n__n__nn_.......__
Type of Wiring:
Armored Cable ............._................
Non-Metallic .......0000.00................._.
Knob & Tube.......nn_nn..................
RIgid Conduit ...............................
MetalUc Tubing mmn.._......n..._....
Raceway ................_._.._........._......_
Circuits, Light.........._....nnn..................
Utility......______.................................
Heat .___________..........._...__........._...._
Range .__._____._...........____._____.............
Water Heater ....h..........._....n.......
Motor .___....................____..__.............
Dryer _.........._.._......_._____............._....__
Furnace ._........................_......_._......_..
Total 00'_0000'."'00__".""""00._'_"00'
~~~~':~?1a1ti~~~;~=~==~~~~-~~~
PCl'Init Fee Treas. Receipt ~, f'
$.'..________________________._________. No.._.........____..__________ By __{d-L<:h_______._fZ..A...!.=-~_~~____
, NOTICE-Current must not be turned on until Certificate of Inspection haa been issued. If work is to be con-
cenled due noUce must be given the Inspector so that work may be Inspected betore concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N~ 1 7660
Address....._._.............._.___..__........_..........._........................................._..._......._......_.__....................Date..._......_......_.._.........._._...._......_h___....
Owner n.......n.___nn_nnn__...n.._......_.._...._..._.n___.........n...n_....._.__.....__.............................. Tenant_...n__nnnnnn__._....n___n......................._.........
WirIng Contractor ........___.....________n..___.................______...__................._....._...._._._.____........._.._.._......... By...................................................._....___..
NOTICE-Current must not be turned on until Certtflcate of Inspection haa been issued. If work Is to be con.
cea.led due notice must be given the Inspector so that work may be inspected before concealment. .,
1M Olympic Printers, Inc.