HomeMy WebLinkAbout321 E 5th Street - Building •
ELECTRICAL PERMIT
CITY QFPORT ANGELES F
360417-4735
AppiiCition Number 17-00001662 Date 11/13/17
Applicati* pin number . . 970072
Property Addreals 321 E 5TH ST REPORT STATE SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-1-7050-0000-
Application type description ELECTRICAL ONLY on your excise tax form
Subdivision Name to the City of Port Angeles
Property Use
Property Zoning PUBLIC BUILDINGS & PARKS (Location Code 0502)
Application valuation . . , 0, •
Application desc
Power and pate Eng. Conference
Owner Contractor
CITY OF PORT ANGELES OWNER
PO BOX 1150
PORT ANGELES WA 983620217
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc .
Permit Fee . . 74.00 Plan Check Fee . . .00
Issue Date . . . 11/13/17 Valuation . . . 0
Expiration Date . 5/12/18
Qty Unit Charge Per Extension
1.00 74.0000 BCH EL-COMM BRANCH CIR WO/ S/F 74.00
Fee summary Charged Paid Credited Due
Permit Fee Total 74.00 74.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 74.00 74.00 • .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN
11 117 /17 "IpiP4)
FINAL /ri 11 7
041:1
COMMENTS:
•
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
•
oY?ORT 4,y„,
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections t
321 East Fifth Street—Port Angeles Washington,98362
Ph: (360)417-4735 Fax: (360)417-4711 IIIIIIIPOr
Date: // ? /7
_Multi-Family or Commercial* Commercial Addition/Alteration/Remodel/Repair*
*Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 3 Z t £ 7--4±1 51--
Building Square Footage:
Description of work I a�Attic- O4.c r t. -r t' 414-r/4 r"i et 14.40 � �0 S p -2. ‘16-1:1110(41
2is.•rt.. _ (CL.A T fC.2.d1 w>
Owner Information Contractor Information
Name: 44 Ty •f AA (GI / OA Lt) Name:
Mailing Addressi Mailing Address:
City: State: Zip: City: State: Zip:
Phone: Fax: Phone: Fax:
License#I Exp. License#/Exp.
Item Unit Charge flty Total(Qty Multiplied by Unit Charge)
Service/Feeder 200 Amp. $132.00 $
Service/Feeder 201-400 Amp. $160.00 $
Service/Feeder 401-600 Amp $225.00 $
Service/Feeder 601-1000 Amp. $288.00 $
Service/Feeder over 1000 Amp. $410.00 $
Branch Circuits 1-4 $ 86.00 $
Branch Circuit WI Service Feeder $ 5.00 $
Branch Circuit W/O Service Feeder $ 74.00 I $ 74. at,
Each Additional Branch Circuit $ 5.00 $
Temp.Service/Feeder 200 Amp. $102.00 $
Temp.Service/Feeder 201-400 Amp. $121.00 $
Temp.Service/Feeder 401-600 Amp. $164.00 $
Temp.Service/Feeder 601-1000 Amp . $185.00 $
Portal to Portal Hourly $ 96.00 $
Sign/Outline Lighting $ 88.00 $
Signal Circuit/Limited Energy I First 1500 sf-Commercial $ 96.00 ,...Ct $
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy-5KVA System or Less $113.00 $
Thermostat $ 56.00 $
$ otal 7 4 v:'
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.C.,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.
Signature f owner,electrical contractor or electrical administrator: ❑ Cash 0 Check
p•—vh......--..........Dated: ❑ Credit Card#
x 1� ?- 17 01/01/2012
EI,ECTRAL PERMIT
CITY OF PORT ANGELES �1
360-417-4735 :, -
Application Number 17-00000225 Date 3/01/17
Application pin number . . 035100
Property Address 321 E 5TH ST REPORT STATE SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-1-70.50-0000-
Application type description ELECTRICAL ONLY on your excise tax form
Subdivision Name . to the City of Port Angeles
Property Use
Property Zoning PUBLIC BUILDINGS & PARKS (Location Code 0502)
Application valuation . . . 0
Application desc
Planning office walls
Owner Contractor
CITY OF PORT ANGELES OWNER
PO BOX 1150
PORT ANGELES WA 983620217
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc . 1-4 CIRCUITS
Permit Fee . . . 86.00 Plan Check Fee . . .00
Issue Date . . . 3/01/17 Valuation . . . . 0
Expiration Date . 8/28/17
Qty Unit Charge Per Extension
BASE FEE 86.00
Fee summary Charged Paid Credited Due
Permit Fee Total 86.00 86.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 86.00 86.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
10/2‹/17 *P colP
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
...._
RECEIVED .„1/43v?"RLING,,,
L) Al..'e.Y )
CITY OF PORT ANGELES PERMIT APPLICATION FEB )r)'? N
Building Division/Electrical Inspections - ff _ 1111
321 East Fifth Street—Port Angeles Washington,98362 ELECTRICAL Lipall11111111111,
Ph: (360)417-4735 Fax: (360)417-4711 INSPECTIONS W. _ 1
Date: 2!7-$ 12 ...mmik
Multi-Famil or Commercial* r ommerc- ,.'tion/Alteration/Remodel/Repair*
*Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 3z t it_ S
Building Square Footage:
Description of work
qt—itS P444
i r 6 WkCk. 143IssC-� Oro.). $u r.:)
7 W N
Owner Information Contractor Information
Name: G t D.r ov I'esitz'- A ILLP9a A Name:
Mailin Address: '32.1_ S 'Sr Mailing Address:
City: ',els.— State: y.D-P-Zip: , City: State: Zip:
Phone: Fax: Phone: Fax:
License#1 Exp. License#1 Exp.
Item Unit Charge Total(Qty Multiplied by Unit Charge)
Service/Feeder 200 Amp. $132.00 $
Service/Feeder 201-400 Amp. $160.00 $
Service/Feeder 401-600 Amp $225.00 $ .
Service/Feeder 601-1000 Amp. $288.00 $
Service/Feeder over 1000 Amp. $410.00 $
Branch Circuits 1-4 $ 86.00 1, $_
Branch Circuit WI Service Feeder $ 5.00 $
Branch Circuit W/O Service Feeder $ 74.00 $
Each Additional Branch Circuit $ 5.00 $
Temp.Service/Feeder 200 Amp. $102.00 $
Temp.Service/Feeder 201-400 Amp. $121.00 $
Temp.Service/Feeder 401-600 Amp. $164.00 $
Temp.Service/Feeder 601-1000 Amp. $185.00 $
Portal to Portal Hourly $ 96.00 $
Sign/Outline Lighting $ 88.00 $
Signal Circuit/Limited Energy/First 1500 sf—Commercial $ 96.00 $
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy-5KVA System or Less $113.00 $
Thermostat $ 56.00 $
$ 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.C., 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.
Signature of owner,electrical contractor or electrical administrator: D Cash D Check
❑ Credit Card#
X Dated: 0110112012
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number 17-00000015 Date 1/05/17
Application pin number . . 122840
Property Address 321 E 5TH ST REPORT STATE SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-1-7050-0000- on your excise tax form
Application type description ELECTRICAL ONLY
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
Property Zoning PUBLIC BUILDINGS & PARKS
Application valuation . . . 0
Application desc
Data wiring
Owner Contractor
CITY OP PORT ANGELES ANGELES COMMUNICATIONS INC.
PO BOX 1150 102 ROSS LN.
PORT ANGELES WA 983620217 PORT ANGELES, WA
PORT ANGELES WA 98362
(360) 457-4375
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc .
Permit Fee . . . . 96.00 Plan Check Fee . . .00
Issue Date . . . . 1/05/17 Valuation . . . . 0
Expiration Date . . 7/04/17
Qty Unit Charge Per Extension
1.00 96.0000 ECH EL-LIMITED 1ST 1500 SQ FT 96.00
Fee summary Charged Paid Credited Due
Permit Fee Total 96.00 96.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 96.00 96.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN lb 4f/ -'-",%;;;:3111'
FINAL '11)114
�7
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
i. 4 �\
CITY OF PORT ANGELES PERMIT APPLICATIONCI).
Building Division/Electrical Inspections EcEivf,- Iwo
., .x
321 East Fifth Street—P.O.Box 1150/Port Angeles Washington,98362
Ph: (360)417-4735 Fax:(360)417-4711 _ JAN,
Date: 2- ../ A9 20/7 Multi-Fao imi ca'
'Plan Review May Be Required,Please Complete Electrical Plan Review Informption Sheet
C J 4
Job Address: 2/2r 1" 5f• og.r / [.-t E$ , 0.-llt t:36 2
Buid'mg Square Foo -: 14,)A/Des* on of above '' -- O. .. L Or' I c./ /n r" , M1
aFP-tce)
Owner (
In gmtti-on a Cont a Information
!
Name: •► y 0f- O R r �1 N 6-6(...E Eme:5 Naftti �E(,E5 Cann r/:�i iLiT)JdJ S
M ' Ad S 5t• Main. -.: i ' c 5 :r
City. State:i1/& Zap: `1 City, c. r .r. (,.-late: Zp:�- cl 3
Phone:36O't'7 1 I I Fax: Phone:A41 S -r+7 571 Fax: 'u 7&- Z...
License#/Exp. _ ,,1 ES t1i 2 1F'21-.�, License#/Exp. (0 j 3 g 4,5 l2 v/3e/,7
tlE Unit Chante gyt Total(Qty Mukio ed by Unit Charge)
Service/Feeder 200 Amp. $132.00 $
ServicFeeder 201-400 Amp. $160.00 $
Service/Feeder 401-600 Amp $225.00 $ •
Service/Feeder 601-1000 Amp. $288.00 $
Service/Feeder over 1000 Amp. $410.00 $
Branch Circuit W/Service Feeder $ 5.00 $
Branch Circuit W/O Service Feeder $ 74.00 $
Each Additional Branch Circuit $ 5.00 5
Branch Circuits 1-4 $ 86.00 $
Temp.Service/Feeder 200 Amp. $102.00 $
Temp.Service/Feeder 201-400 Amp. $121.00 $
Temp.Service/Feeder 401-600 Amp. S 164,00 $
Temp.Service/Feeder 601-1000 Amp. $185.00 $
Portal to Portal Hourly S 96.00 $
Sign/Outline Lighting $ 88.00 $
Signal Circuit/Limited Energy-Multi-Family $ 64.00 $
Signal Circuit/Limited Energy/First 1500 sf-Commercial $ 96.00 / $ f(v
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy-5KVA System or Less S 113.00 $
Thermostat $ 56.00 $
Note:$5.00 for each additional T-Stat
$ 7( 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.C.,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.
Signature of oymer,elect it l contractor or electrical administrator: 0 cam, 0 Check
fcrime carr Q3 F 1
x , Dated: �f�* `i t 2 17 oran/zotz
9 i
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
•
Application Number 17-00001080 Date 8/09/17
Application pin number . . 826760
Property Address 321 E 5TH. ST REPORT STATE SALES TAX "
ASSESSOR PARCEL NUMBER: 06-30-00-0-1-7050-0000- '
Application type description ELECTRICALONLY on your excise tax form
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
r _
Property Zoning PUBLIC BUILDINGS & PARKS
Application valuation . . 0
Application desc
Generator Load Bank
Owner Contractor
CITY OF PORT ANGELES LEGACY TELECOMMUNICATIONS INC
PO BOX 1150 PO BOX 360
PORT ANGELES WA 983620217 BURLEY WA 98322
(253) 858-0214
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc .
Permit Fee . . . 223.00 Plan Check Fee . . .00 •
Issue Date . . . 8/09/17 Valuation . . . . 0 '
Expiration Date .' 2/05/18
Qty Unit Charge Per Extension
1.00 102.0000 -ECH EL- COMM 0-200 TEMP SRV / FDR 102.00
1.00 121.0000 ECH EL- COMM 201-400 TEMP SRV/FDR 121.00
Fee summary Charged Paid Credited Due
Permit Fee Total 223.00 223.00 .00 .00
Plan Check Total .00 .00 .00 .00 - •
Grand Total 223.00 223.00 .00 .00
INSPECTION TYPE DATE RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN gJ J7/1-7 + - *.p,11111PFINAL
$
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
Aug. 2. 2017 11 : 26AM No. 7923 P. 1
RE, I ,.-cEi .,,,!: Ori pc�Rr� t
'&, ifs
CITY OF PORT ANGELES PERMIT APPLICATION 'i'=c. ��;.
Building Division/Electrical Inspections W liblail (:.9
321 East Fifth Street—P.O.Box 1.150/Port Angeles Washington,98362 ,--. :;i''. :.
Ph:(360)4174735 Fax:(360)417-4711 :'" hi:.
F
Date ;lZ 2-1I'�_ _Muamily
•Cgt::.
'Plan Review May Be R-•uired,P -- Complete Electrical Plan Review Information Sheet
Job Address: ' 21 E. 1k - 'aC A • -l
Bu9dtng Square F• -:
ar eboue O• .its A . • _ .. !ti._ 7* • . K 2 a` Q 11 • Ct►C1'('-e time
Dgy 0• • '.1i C[ 0 e Oar-4wIRIIit -4-
Owner Informata Contractor information
Name: C r- oa .0 -ATI 4e%eS Nam___Qe ,C•L P Wer
Nailing Address: Melling Address: P•b. -Ox 3/0c 2�
Ci7 State: BP! city 4Sustoic - A -
Phone: Fax: Phonclear Ora% 2 1 '- 02 4
Lkense#i Exp. License#!Exp. 1_14T i 00 V.-
Unit
Unit Charge a Toad(Qty Multiplied by Unit Charge)
Service/Feeder 200 Amp. $132.00 $
Service/Feeder 201400 Amp. $160.00 $ _,
ServioelFeeder 401 Amp $225.00 $
Service/Feeder 601-1000 Amp. $288.00 $ -
Service/Feeder over 1000 Amp. $410.00 $
Branch Circuit W/Service Feeder $ 5.00 $
Branch Circuit W/0 SeMce Feeder $ 74.00 $
Eats Additional Branch Circuit $ 5.00 $
Branch Circuits 1-4 S 86.00 $
Temp.Service/Feeder 200 Amp. $102.00 t $ O'1 .iQ
Temp.SeMcelFeeder 201-400 Amp. $121.00 $ 1L t.00
Temp.Service/Feeder 401-800 Amp. $164.00 $
Temp.Service/Feeder 601-1000 Amp. $185.00 $
Parol to Portal Hourly $ 96.00 5.
Sign/Outline Lighting 5 88.00 $
Signal Circuit;Limited Energy-Medd-Family $ 64.00 $ -
Slgnal ClrcuM/Limited Energy/First 1500 sf-Commercial $ 96.00 - $ .
Note: $5.00 for Bath addbonal 1500 sf
Renewable Electrical Energy-SKVA System or Less $113.00 $
Thermostat $ 56.00 $
Note:$5.00 for each additional T-Stat
$ 7-23.° 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 tam the owner of the above named property or a licensed electrical contactor.I am making
the electrical installation or alteration in compliance with the eledrical laws,N.EC..RCW.Chapter 1928,WAC.Chapter 296-48B,The City of Port
Angeles Municipal Code,and Utility Speciacgtlons and PAMC 14.05.050 regarding Electrical Permit Applications. �-p
Signature of owner,electrical contractor or electrical administrator: ❑ cath 0 Cbeete 1 %.&Lw.-.CC1- 1')14.11.
1cFada Cara _
ELECTRICAL PERMIT -
CITY OF PORT ANGELES -
360-417-4735 15'-
Application Number 16-00001638 Date 11/01/16
Application pin number . . 183332
Property Address . . . . . 321 E 5TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-1-7050-0000- REPORT SALES TAX
Application type description ELECTRICAL ONLY on your excise tax form
Subdivision Name
Property Use to the City of Port Angeles
Property Zoning PUBLIC BUILDINGS & PARKS (Location Code 0502)
Application valuation . . 0
Application desc _ •
Install AP cables and equipment
Owner Contractor
CITY OF PORT ANGELES CTS
PO BOX 1150 ' 2720 S ASH ST
PORT ANGELES WA 983620217 TACOMA WA 98409
. Permit ELECTRICAL ALTER COMMERCIAL
Additional desc .
Permit Fee 161.00 Plan Check Fee .0.0
Issue Date . . . . 11/01/16 Valuation . . . . 0
Expiration Date . . 4/30/17
Qty Unit Cb4Yge Per Extension
1.00 96.0000 ECH ''EL-LIMITED 1ST 1500 SQ FT 96.00
13.00 5.0000 ECH EL-ADDNT LIMITED 1500 SQ FT 65.00
Fee summary Charged Paid Credited Due
Permit Fee Total 161.00 161.00 .00 .00
' Plan Check Total - .00 :00 .00 .00
Grand Total 161.00 161.00 .00 .00
•
•
•
INSPECTION TYPE DATE: RESULTS: INSPECTOR
DITCH
•
SERVICE
ROUGH-IN
FINAL - 1)41-7 147 1C:4>.
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
GIEXCHANGE BUILDING
i
l
CITY OF PORT ANGELES PERMIT APPLICATION ,1_� W
Building Division/Electrical Inspections / 1,'. tori
321 East Fifth Street—P.O.Box 1150/Port Angeles Washington,98362
Ph: (360)417-4735 Fax: (360)417-4711 NIIIMPF
Date: 10/26/2016 _Multi-Family or Commercial*
'Plan Review May Be Required,Please Complete Electrical Plan Review Information Sheet
Job Address: 321 E 5th St Port Angeles,WA 98362
Building Square Footage: 20,000 sq ft
Description of above Install 1051 AP cables 1051 locations and install AP equipment
Owner Information Contractor Information
Name: City of Port Angeles Name: CTS
Mailing Address: 321 E 5th St Mailing Address: 2720 S Ash St
City: Port Angeles State: WA Zip: 98362 City Tacoma State: WA Zip: 98409
Phone-MO-417-4735 Fax: 360-417-4711 Phone:206-886-2000 Fax: 206-686-2000
License#1 Exp. License#/Exp.CTS"TS881 BK
Item Unit Charge gty Total(Qty Multiplied by Unit Charge)
Service/Feeder 200 Amp. $132.00 $
Service/Feeder 201-400 Amp. $160.00 $
Service/Feeder 401-600 Amp $225.00 $
Service/Feeder 601-1000 Amp. $288.00 $
Service/Feeder over 1000 Amp. $410.00 $
Branch Circuit WI Service Feeder $ 5.00 $
Branch Circuit W/O Service Feeder $ 74.00 $
Each Additional Branch Circuit $ 5.00 $
Branch Circuits 1-4 $ 86.00 $
Temp.Service/Feeder 200 Amp. $102.00 $
Temp.Service/Feeder 201-400 Amp. $121.00 $
Temp.Service/Feeder 401-600 Amp. $164.00 $
Temp.Service/Feeder 601.1000 Amp. $185.00 $
Portal to Portal Hourly $ 96.00 $
Sign/Outline Lighting $ 88.00 $
Signal Circuit/Limited Energy–Multi-Family $ 64.00 $
Signal Circuit/Limited Energy/First 1500 sf–Commercial $ 96.00 14 $161
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy-5KVA System or Less $113.00 $
Thermostat $ 56,00 $
Note:$5.00 for each additional T-Stat
$161 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.C.,RCW.Chapter 19.28,WAC.Chapter 296-46B,The City of Port
Angeles Municipal Code,and Utility ppecifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Sigr a ure of ow er,elect cal co tractor or electrical administrator: 0 Cash 0 Check
l
Credit Card* ' �� ( � _ IYI f ''�
x `r. J '.�.i Dated: 10/26/2016 0110112012
��t(E'`\V1 UJe-O'('_-t—
/,;," ELECTRICAL INSPECTION
WIRING REPORT
417-4735
DATE: PER4./i q it6 M��� INSPE
OWNER
CONTRACTOR
GYM O' tG
ADDRESS
32J rte- SS1�
APPROVED NOT APPROVED
O DITCH ❑
Cr ROUGH IN/COVER
O SERVICE ❑
❑ FINAL ❑
CORRECTIONS NEEDED: �x+►� A L(.. L.
c z-)1 (44,s GdJ1F- z, Az i 10 MD
1'.1,x..G 110 0 rah
h
1414.7— A 4 ' hta�-r a=igy*"rriz_ 1Q
At*L 353.30
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
— DO NOT REMOVE---