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ELECTRICAL PERMIT APPLICATION
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TTe ElECttiCel Permit /1pplicaDOn mltsl 0@ IIY00 OYt COTGlelsiv
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Please type or reprint in Ink. rt you have any quesltons, please ca►I (36D. �17-4735
Fax num6er. (36p) �1T�717
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Owner or Elec. Coniractor Agenh �,073- s
Phone: Faz
Praperty Owner. l.J`G�� Phone:/ �:3(i�i 7�"{ G: ��U/
Address: �i G'
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Electrical Caitracbr, l/) i'�! E� GlTL/
Licerise K: Exp: Phone
Address: i�� }�f� L---.=i_
Ciry: i� /J�l C� ZP� �'"7� �S
INSTALI,.A710N WIRED BY: pyy�p EIECTRICq� CpMfqqCTOR
Credll Card Ho/der 1N�me: !J
B;u�R adaress: S�� c:.J G, a:i���_� d' 3� Z_
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Credit Card Number. � . Exp. Date: .
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PROJECT AppqE55: C
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TYPE OF WORK: Check all thai appfy: O New AtteratioNAddiGon
�Residental Mutti-family t� Commercial D Mobile Home Sq. Ft.
Remote Meter Detached garage �=1 Hot Tub O Swim Poo► p Septic Pump Low Voltage Telecom. O Sign
Number of Qrcuits added or altered:
DESC�P N OF THE ELECTRICAL PROJECT: r�i� �r
o r�"
Electrical Heat �oed Additions
Servlce Information
Baseboard _�(yy
U Fumace Kyy Vouage:
Fleat Pump Kyy Overhead Service
Pbase: t D 3
O Fan-Wall Kyy J Temp Service Senrice Slze:
O Underground Service Feeder Size:
PAMC 14.05.060(B): Fvr industriat, commercial, residentlal proje�ts larger Ihan a duplex, a one tine drawing of th6 ElecUical ServiCe 8
Feeders, buildmg size (sq_ R.), Ioad calculations, and the type 8 ot condudors and/o� raceway is required and shall accompany the
Electrical Permil applicalion.
I hereby ce�tily that I have r�ad and examined thrs applicafion and know that same to be true and cor�ect and I am
authvrized to app/y /or lhis permit. understand i� is nv[ ihe City's lege/ responsibi/ity to deteanine whaf
are required; it rremains [he app/icants responsibi7ity to defermine what P��RS
pe�miis are required and to obtain such.
C�edit Card Molde�'s Signature:
-L Date:
Owner or Etec. Coot. SignaWre:
P W -9019 Dete:.__________
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
321 F. AST 5TIt STREET. PORT ANGELES. WA 98362
ELECTRICAL PERMIT ISSUED: 12/19/2001 PERMIT NO 7493
OWNER/APPLICANT PROPERTY LOCATION
Lilliana Schuler 529 WHIDBY
P.O. Box 11849 Lot:
olympia, WA 98508 Block: [] Long Legal
360/786-6001 Subdivision:
T: S: Parcel No:
CONTRACTOR ARCHITECT
COLEMAN ELECTRIC N/A
PO BOX 1326
PORT ANGELES, WA 98362 , 98360-0000
360/452-7594 360/000-0000
PROJECT INFO
Project Type: RES. MISC. Project Value: $0.00
Occupancy Type: Construction Type: SERVICE CHANGE
Occupancy Group: Zoning Use:
Electrical Heat:
[] Baseboard 0 KW [] Riser [] Underground Service
[] Furnace 0 KW [] Overhead Service Voltage: 120,240
[] Heat Pump 0 KW [] TempService Phase: [] 1 []
[] Fan Wall 0 KW Service Size: 200
Feeder Size: 0
PROJECT NOTES
200 a. service upgrade
FEES ASSESSMENT Service: $63.20
Additional Feeders: $0.00
Circuit Wiring: $0.00
Temp Service: $0.00
Misc Fee: $0.00
TOTAL FEE: $63.20
AMOUNT PAID: $63.20
BALANCE DUE $0.00
('OMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL I/qSPECTIONS. PLEASE PROVIDE A MINIMUM :24 HOUR NOTICE. ITIS UNLAWFUL TO COI~ER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
DITCH
ROUGH-IN / COVER
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FINAL It ~/r*/e t I ~ I
GENERAL COMMENTS: