The URL can be used to link to this page

Home My WebLink About402 E Lauridsen Blvd - Building(-7,0- to -Na- K 40/ E. 1,61f' Pankaz- 6-6JYY,42_,4)-ae,LAD ra2, 2 25110 J yv.ad4 AD +a- yakemmy. CE'RTIFICATE OF OCUPANCY City of Port Angeles .BUildk00,Pivision 4 This certificate is issuedtpurSOnt to the requirements of Section 110. ofthe 2006 International Building Coder certifying that at the tiine,401004:114'is4tructure was in compliance with the various ordinances of the City regulating building cpnstraCtiok0;ase for:- Business name 4* (O0).0,k‘,,eire'_$_.,,iahlh;parterOn) Business address 21`.627E.Laurid§erl:1014 Property owner North Olympic 5:. 41 .0:141kfirar9, Property owner s 4ddreSS:, 2210 S PealjOtty: S Po 98362-6536 Automatic fire sprinkler system. Per 11E,I;Q: I Use occupancy .classification Business -1 Building permit number 44:60a,.„. '04:44fei' Type of construction. VENIN-4 Occupant load. Per, IBC :7.171 r :ue en, 41a-m41g manager Date --424arm conspicuous place. This &lint not be removed except by the-Building Official. c> PREPARED 1/14/10 8 31 35 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 1/14/10 ADDRESS 402 E LAURIDSEN BLVD SUBDIV TENANT NBR H R BLOCK CONTRACTOR PHONE OWNER NORTH OLYMPIC LIBRARY SYSTEM PHONE PARCEL 06 30 10 5 0 9080 0000 APPL NUMBER 10 00000008 CO CHANGE OF OCCP /USE PERMIT CO 00 CHANGE OF OCCUP /USE REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS C099 01 1/14/10 BLDG C/O FINAL TIME 01 00 OVERRIDE TAKEN BY LPANGRLE DATE 01/13/10 TIME 08 45 48 January 13 2010 8 44 42 AM 1pangrle DENISE 457 8040 C OF 0 FINAL H R BLOCK AFTERNOON COMMENTS AND NOTES Print in ink BUSINESS NAME J/rh 4/j BUSINESS ADDRESS Business mailing address /51 �3 J Opening date /ri -iv Days Washington State Tax 1 D Brief description of proposed business Business owner's name ry 4`,),,,,.,, Phone ri, 9 Business owner's home address v •PLEASE'NOTE: A Business License is also required forthe following businesses. Taxi Peddlers Second -hand dealer Pawnbroker Dance :Hotel Motel Fireworks, Ambulance Tattoo shop Contact the City Clerk at 417 -4634 for additional information. ACTION New business Transfer of business -location from a PBIA location Transfer of business location from a non -PBIA location Change of ownership Remodel Temporary business Change of use Call for Certificate of Occupancy inspections before openina business. Building Department Inspection 417 -481.5 Fire Department Inspection 417 -4653 Please provide a minimum 24 -hour notice for inspections I hereby apply for a Certificate of Occupancy I acknowledge that 1 have read this appli supplier ct to the best of my knowledge Date gaId Print Name For City use only Department Building Fire PBIA Planning City Clerk Public Works T:Forms /Bud lg Di CERTIFICATE OF OCCUPANCY APPLICATION Permit CITY OF PORT ANGELES Attn Building Permit Technician 321 E. Fifth St. Port Angeles WA 98362 r $100 00 (360) 417 -4815 fax (360) 417 -4711 Approved gnitiais date 314 I -14 -(0 K DI) 1- 11-1=1,o SR 1 -13 -10 c� 1 if 1 -15- ID Rejected Initials date sic /Certificate of Occupancy Application $60 00 1- 1 0 6Z G t'Gt Fi riser) Mot Zoning C 0 `4 hone X255 7d-,5 hours of operation p, 1-9 L.T rs 5 v If known list the name of the previous business at this location WILL THERE BE ANY OF THE. FOLLOWING? NO/ YES/ Electrical'changes 1 New or relocated signs rP -face. an exisf) ilium) 5i9 h Construction changes _J I Mechanical changes (ventilation, heating, cooling, etc.) t/. Plumbing changes Fire sprinkler system changes t/i Fire alarm system changes New or relocated sewer or water service Excavation or filling of lots Work done in the City right -of -way New driveway openings Grading site drainage (parking lots, downspouts, etc.) Landscape irrigation system (backflow devices) t/ Is this a home occupation? Is this a second -hand dealer or pawnbroker business? Is there off street parking for this business Is the street in front of this business paved? Is there a sidewalk in front of this business? Is there a curb gutter in front of this business? K 1 vtci Signature A 8R AN_ 0 Manager U FEES Certificate/ Inspection Parking Business Improvement Area (PBIA) fee charged for downtown locations bh �i ST96 a Comments Conditions Type of construction Occupant Load Automatic fire sprinkler system required no yes X 7 ‘i171 IF YES CONTACT Electrical Dept. at 417 -4735 Building Div at 4.17 -4815 Public Works at 417 -4807 Water Dept. at 417 -4886 Planning Div at 417 -4750 City Clerk at 417 -4634 How rnany spaces? "7 Please sign up for utility services at the cashier counter 'tion and state :that the. information :I have 2o6 (00ag r r t Cf K.> CERTIFICATE. OF OCCUPANCY City of Port Angeles, Building Division This Certifi'CaiiOn issued pursuant to the requirements of Section 109 of the Uniform Building certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating Building construction orl:se. For Use Classification: Office Building Permit No. tittsing None: PaUleitt ch Piano Academy Group B Building Address: 402 ype of Construction VN Use Zone CO BIthntffifi Post on theor Shall not be removed excep Owner of Business/Residence: Paulle Sharon Creech„ Adtlies:40613etrinion Rd:Tort Aneeles. WA 98362 .rt..An les: WA 98362 gust 1 2002 Date ft spidbous place t-by Building Official DATE V/ hYo Address of Proposed Business pp n;� E. L fser. U I00. Applicant &t c irri. C",sr ce cll.� Address 0 4- e vrt 6' c,) A 4 g'3 _a Phone business '157 66( home `/S ");IM Brief description of proposed business. Mu s i a Legal Description Lot Current Use of Property Zoning Classification of Property WILL THERE BE ANY OF THE FOLLOWING? Construction changes Electrical changes Mechanical (heating, cooling, stoves) Plumbing changes New or relocated signs New septic tanks New sewer service Admission charged to patrons Is this a home occupation? Excavation of filling of lots Work done in City right -of -way Is there sufficient off street parking? New driveway openings A grading plan for site drainage (parking lots, downspouts, etc.) Are the existing streets paved? Are there existing sidewalks? Is there curb and gutter? Other I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the information I have supplied is correct to the best of my knowledge APPROVED 7/u/aa sr� 7 7 /zZ/p zeu JECTED Building Section Public Works Department Planning Department Fire Department City Clerk PB I.A. ROUTING SLIP Po.vk C., e. (3 8 Certificate /Inspection Fee AA, L.A.5 Certificate of Occupancy YES NO Block New Business Transfer of Business Location Change of Ownership New Building Remodel Temporary Business Change of Use Date THE FOLLOWING WILL BE REQUIRED PERMITS 1) Building 2) Plumbing 3) Electrical 4) Mechanical 5) Sewer 6) Sidewalk installation 7) Driveway installation 8) Curb installation 9) Sidewalk obstruction 10) Water meter installation 11) Fire 8 3 Occupancy Sign 14) Shoreline 15) Home occupation 0 Conditional use 17) Other t 810 Signed !..)0.*' .Q Comments Conditions Z� Subdivision BUSINESS LICENSE 1) Taxi 2) Peddlers 3) 2nd Hand Dealer 4) Pawn Broker 5) Dance 6) Hotel Motel 7) Fireworks 8) Ambulance 9) Tattoo shop 10) Other cw& CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT ISSUED: 8/02/2002 PERMIT NO: 13601 OWNER/APPLICANT PROPERTY LOCATION N.O.P 402 LAURIDSEN BLVD E 2210 S PEABODY Lot: 6,7 Port Angeles, WA 98362 Block: 21 [] Long Legal 360/417-8504 Subdivision: PSCC 2ND ADD T: S: Parcel No: CONTRACTOR ARCHITECT COPY CAT GRAPHICS N/A 3234 HWY 101 E PA, WA 98362-0000 , 98360-0000 360/452-3635 360/000-0000 PROJECT INFO Project Value: $0.00 SFD Units: 0 Commercial: 0 Project Type: SIGN FACE SFD SQ FT: 0 Industrial: 0 Occupancy Type: COMMERCIAL Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: RS7 PROJECT NOTES INSTALL NEW SIGN FACE FEES ASSESSMENT Building Permit: $0.00 Misc Fee 1: $0.00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $0.00 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 Sign: $30.00 TOTAL FEE: $30.00 Plumbing: $0.00 AMOUNT PAID: $30.00 Mechanical: $0.00 BALANCE DUE: $0.00 Radon: $0.00 Separate Permits are required for electrical work, SEPA, Shoreline, ETA, 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 for a 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. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\PLANNTh~G\FOP.~S\ I ] 02.1 $ [4/2002 ] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. , EEP PERMI',' CA ,*ND APP .OVED PLANS JOB SIT, I 5 I INSPECTION TYPE [ DATE [ YEsACCEPTEDI NO COMMENTS FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # FLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER aiR SEAL FRAMING JOISTS / GIRDEP~S SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHI~EY HOOD / DUCTS PW UTILITIES / SITE WORK (Enginecdn8 Div~slon) SEPARATE PER~41T #'s~ WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PER~IT #'$ SEPA~ PARKING/LIGHTING ESA: LANDSCAPING $HOP~ELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R,W~ ENGINEERING 417 4807 FW / ENGINEER~NG FIRE 417-4853 FIRE DEPT. PLANNING DEPT~ 417-4750 PLANNING DEFT. I:\PLANNING\PORMS\1102.15 [4/2002] FOR OFFICIAL USE ONLY: &-kO~ ~P O RT 4~'~Q~" Date Rec.: °~% BUILDING PERMIT- APPLICATION Date Approved: Date Issued: The Building Permit ~pplication must be filled out completely. Please type or print in in~ If you have any questions, please call 417-4815 Applicant or Agent: ~gm( ~ ~ C~e~ Phone: ~S ~ - ¢66 7 Owner: ~r~ ~(~[e L:h~o~ ~e~ Phone: ~[7- Contractor ~pc,~0~ff ~r~k~o~ License~:~o~ c~ . Exp:~/S/cg Phone: Address: ~) gq fl~%/01 F City: ~w'? ~(~5 Zip: q g3~ PRO~CT~D~SS: ~0~ ~ ~id~e~ Aio~ zom~a: LEG~ DESC~PTION: Lot: Block: Subdivision: CL~L~ COUNTY P~CEL NUMBER: G~ ~ Q l O - 50 ~0g~edit Card Holder Name: Billing Address: City: Credit Card g: Exp. Date: ~SA MC T~E OF WO~: SIZE~UATION: ~ Residential ~ NewCom~. E Re-roof D Wood-stove q~.~ SF. ~ $. /SF. D Multi-fa~ly ~ Addition ~ Move D Garage SF. ~ $. /SF. = $ D Co~ercial D Remodel ~ Demolition ~ Deck SF. ~ $. /SF. = [ ~ Repak ~ Si~ ~ TOTAL VALUATION $ B~EFDESC~PTIONOFTHEPRO~CT: fi{net (~ ntG St'a~ ,~t~e~ ~C ~[s~[~, COMMERCI~S~ENTI~: Occupancy Group: Occupant Load: Cons~cfion T~e: No. ot Stories: [ Lot Size: % Lot Coverage: % Exist~g Lot Coverage: /sq. fl. + Proposed Lot Coverage: /sq. ff. = TOTAL LOT COVE~GE:. ~/~q. PL~G USE ONLY: ~PROV~S: x ~ DPW FI~ ES~Wetl~d(s): ~ Yes ~ No SEPA Checklist required? ~ Yes ~ No O~er: OTHER BUILDING PE~IT ~PLICATION S~MITT~: Your application and site plan must be filled out compl~ely to be accepted for review. The Building Division can provide you with more detailed info~ation on ~e application and plan sub~al requ~ements. Your completed application, site plan (for additions) and building cons~ction plans are to be subdued to the Bulldog Division. V~UATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. T~s ~g~e will be reviewed and may be revised by the Bulldog Division to comply with cu~ent fee schedules. Contact the Pe~t Coordinator at 417-4815 for assistance. PL~ CHECK FEE: Yo~ plan cheek fee is due at the t~e the building pe~t application and cons~ction plans are subdued. All other pe~it fees are due at the time ofpe~t iss~nce. EXPIATION OF PL~ ~EW: If no pe~t is issued with~ 180 days of the date of application, this application will expire. The Build~g O~cial can extend ~e time for action by the applicant up to 180 days upon ~i~en request by the applicant (see Section 107.4 · e Unifo~ Building Code, cu~ent edison). No application can be extended mo~e ~an once. I hereby cert~ that I have read and examined this application and know t~e same to be t~e and correct, and I am authorized to apply for this permit. I ~nderstand it is not the Ci~'s legal responsibility to determine what permits are required; it remains the applicant's responsibili~ to determine what permits are required and to obtain such. Applicant: .~)~ ~<~e~ Date: ~/t /O~ T:~FO RMS~PPS~B uildin~emfit l SITE PLAN ~]~E~O~ ~.u~ wo.,~...,,..,.~ 0~. ._ APPLICANT J~),~.,, ~.. ~L ~ -- ' ' I I I I~ ....... ' i~ -- lmll ,,, ,,,, L~, Gl ~.1 I ,' ~1 I!1~ CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date <~-/~ -F_..7--(~ Time Received by ~'~ ~// {phone, person) Location of Work to be inspected /~/~ ~-----~.~ ~*~=,~-~ ~ ~\_ Name of person requesting inspection '(~-- Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. Sewer Foundation Framing Chimney Plumbing~Fina~Sewer Excav. Other INSPECTION NOTES: Inspected: Date ~'J -~ Time By Remarks: RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved [~Gravel [-~Asphait [~PCC []Other [] Repaired by City Work Order # [] Repaired by Permittee ~'~ COMPLETE [] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) ROUTING SLIP ~o.~.( 'C:_~-~c,~, ~. V Certificate of Occupancy ~.;j>,~_~ ~. ~- $47,00 Certificate/inspection Fee ,,~.,~,.~, c. O.o_c~C. Jc~c,.~ DATE New B, ina, ............................ Address of Proposed Business Transfer of Business Location ................ ~C3o3. ~. L~,~_~z~-~'~sv~.~ ~, Change of Ownership ...................... Applicant fO~.~ ( ~ ~/~L~rO~,- ~.~('~----E~.~ New Building ............................. Address ~/0(~ ~.,~v-/t~ j~,_.~ Remodel ................................. ~O~y.~ ~.~_~ ~_~, &~ ~'~G.JZ Temporary Business ....................... Phone: business ~-~ ~ - GGC, -~ _ home ~,~',3 o ~'lb Change of Use ............................ Brief description of proposed business: J~_,3t'e ,~~ /.~"J-/~.. J.~.~_~o~' -/- Legal Description: Lot Block ' Subdivision Current Use of Property: Zoning Classification of Properly:. WILl. THERE BE ANY OF THE F~LLOWlNG? YES NO THE FOLLOWING WILL BE REQUIRED: Construction changes ............................ '~ PERMITS BUSINESS LICENSE Elec~cal changes .................... '~ 1) Building 1) Taxi Mechanical (heat/rig, cooling, stoves) ........ ~'~ 2) Plumbing 2) Peddlers Plumbing changes ............................. ~ 3) Electrical 3) 2nd Hand Dealer New or relocated signs .......................... ~ 4) Mechanical 4) Pawn Broker New septic tanks ................................ ~ 5) Sewer 5) Dance New sewer service ............................. v~ 6) Sidewalk installation 6) Hotel - Motel Admission charged to patrons ................ ~ 7) Driveway installation 7) Fireworks Is this a home Occupation? ...................... v~' 8) Curb installation 8) Ambulance Excavatiotl of filling of lots ....................... ~ S) Sidewalk obstruction g) Taltoo shop Work done in City right-of-way. / 10) Water meter installation 10) Other Is there sufficient off-street parking? ............... ~ ~ 1i) Fire New driveway openings .......................... ~ Occupancy A grading plan for site drainage.. / i~ Sign (parking lots, downspouts, etc.) .................. ~ 14) Shoreline Are the existing streets paved? .. ~ 15) Home occupation Am there existing sidewalks? .......... ~'~ (~ Conditional use Is there curb and gutter? ........................ ~ 17) Other Other ........................................... I hereby apply for a Certificate of Occupancy and acknowl- 7/ edge that I have read this application and state that the Date: information I have supplied is correct to the best of my knowledge. Signed: APPROVED REJECTED Comments / Conditions Building Section Public Works Department Planning Department Fire Department City Clerk CERTIFICATI OCCUPANCY This Certification issued pursuant to the requirements of Section 109 of the Uniform Buildittg Code certifying that at the time of t~suance this structure was in compliance with the various ordinances of the City regulating Building Use Classification: Office Piano Academy Group: B of Construction: Owner of Business/Residence: WA 98362 Building Address: 402 ] WA 98362 2002 Date Post on the place. Shall not be removed except by Official. !ftd':~ER ! CITY OF PORT ANGELES DEPARTMENT OF LIGHT APPLICATION AND ELECTRICAL PERMIT A /~0~ PERMIT NUMBER . TOT L FEE )&? 'Rpj TIMETO COMPLETE NO. STORIES LEGAL OCCUPANCY ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT Site Address '10 ?. CORRECT ADDRESS IS A PONSIB1L1TY OF APPLICANT PERMITS WITH WRONG ADDRESSES ARE CANCELLED Owner--t<o^- 10; \\'),..",\<.<.. Installation By '~C<~"'\'ll~ .'l.e"A <,t~..... Owner's~dress i/o).. ~ _ Lc....,.;.I'~A Dl.t.\, Installers Address ;]..?51 p",~.e ~J. Day Phon, Installers Phone ...i~ J... - ,,';). 2Lj Applicatidn is hereby made for Permit to install Electrical Equipment as follows: ,.. ....A.~ A ) . 't":,.e~!}J "..~ r -~~l'\-r (l~^^-cc +- ()\",-e ~llp"X /<./' N",.\-':; .J, "t "'- . i i. ~ ".h'....~. n rl'... ; -\- , sv.c,+-eoM.. , Wiring Method <,,,,,cL,,,: .\.- . NUMBER AMP 120V 240V NUMBER AMP 120V 240V USE OF CIACUIT PEA 100R FEE USE OF CIRCUIT PEA 100R FEE CIRCUITS CIA 10 30 CIRCUITS CIA 10 30 LIGHT SIGN I I~,P, )( .1 nQ _Llo' LIGHT 50 VOLTS OR lESS CONVE/olIENCE MOTOR . . CONVENIENCE MOTOR , APpu,e.NcE MOTOR . DISHWAsHER FIRE ALARMS - DISPO$AL BUAGLAA ALAAM RANGE; MISC. , OVEN WATE~ HEATER LAUNQRY . . DAYER REINSTALLATION LIGHT FIXTURE # FUAN1CE - SUB TOTAL FEE GAS - OIL FURj\fE ENERGY FEE ELECT Ie BASIC FEE ELECTRIC HEAT TOTAL FEE ;21 n~ ElEC11R-IC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER A.c.ulm AMP PHASE FEED~A SIZE OF SERVICE ENTRANCE CONDUCTORS SERVICE AW.G. I SUB-TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH . ~A/;;ued I WARNING I certifr that the work to be performed under this permit will be done by the installer and in conformance with Date Application made' A / ~ ,19 87 BY' .---::- , CONTRACTOR OR OWNER (OR parmission is hereby given to do the above described work, according to the conditions hereon and according to t specifibations pertaining thereto, subject to compl"iance with the Ordinances of the City of Port Angeles. : -~. '." ~DIRECTOR OF CITY LIGHT By '.-J . .. PLANS APPR VEO. ,- , :".. -. ~. Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be covered or current turned on before inspection and O.K. for covering or service has been given by Inspectorin Writing on Permit Placard. A.. Permits Phone: 457.0411 Ext. 158. PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _ WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report OL YMPjC PRINTE!,!S, INC. REPORT OF INSPECTOR DATE OF VISIT MADE BY REMARKS . , 00. . , . .. . . . . . . O.K. FOR COVERING O.K. TO CONNECT SERVICE i?btltl '"""h, FINAL O.K. ., ' /CT '. '. . z Cl a: < :!! !a J: I- Z w ie I- o Z o Q . CITY OF PORT ANGELES LI~HT DEPARTMENT ELECTRICAL PERMIT N? 155J.3 Port Angeles, Washlngton...................._........................................ 19........ In accordance with the City Ordinance to regulate the InstaJJatlon, extension. or repair of elec- trical equipment In, on. or about any building or other structure In the City of Port Angeles. per- ml$sion is hereby granted to do electrical work as listed below. Address ............................,.~.....m......,............................................ Occu pancy ......:...........::::.:........._............. Owner .....~.!...!..L.............,.,.,......,.............................. Tenant................................._................_..................... Wiring Contractor .............................................................~... By................................................._..m........._... LIllht Outlets.......................................... Re~eptacle Outlets_mm_.._..........n........ Dryer, KW.....n_n..n........_......._.....___... Service, volts ............m..:._.._....m_n..... No. wires __..n..____.n_.__._........_...n_... 3'" '4' Size wires......................=:.........._.. Main fuse unn~_..mm_mm~..n_m...... Range, KW ____nn_.....__.__.____...__n_. Welter Heater: Enclosure .......~....._......n..._...._....... KW.................................... He." KW........!....~:.!..)........I.!..~L......... Type of wiring: Entrance Cable ..mnmm.__..... Motors: size, volts and phase: Rigid Conduit ............................... Metallic Tubing ........................... Current transformers: No. & Size....................................... j . , .-..--......................-.---..---.._.._............. Ser. No............................................... Ser. No. n__nh........._n..........n_n_n_u... Ser. NO..___._.n._....___...nn................n... Total Load.m.......mnm_mm... Ser. No. ..nnun..n__._.._nn_.._......_._.._. Remarks: ..........................:........___...................................................................................................................... Total....................................... Type of Wiring: Armored Cable ................._...._..__._ Non.Metalllc ................................. Knob & Tube.................................. Rigid Conduit ............................... Metalllc Tubing ........................... Raceway ....._._.........._............___._ Circuits, LIght....................................._. Utility............................................. Heat .____...._.......__...................._...._ Range .....______.__.._.___._...................... Water Heater ............._................. Motor ..__.._................................._.... Dryer ..........._______........____.....__..___.__.__ Furnace ..._......................~_...._____.__..... .._..________._u__.u._...nn_____n___n________._._._u__....____.______uu___._n___.______u__._.u.__..__.__._._._.___u_____n______n_uu_u__nu____u_u____.__.__ PClJIllt Fee .n_.n_n_.____n_nuu__nnn_U._unnnn_nuuunnn..._._._nnnnun.n_"nn__nnnun_.u.nn__..nnUh..u__n_nnnnn.nn_nun_."'''h__.uu._. $............................___....... Treas. Receipt No............................. By...:........................................:............:........:... NOTICE-Current must not be turned on until CertifIcate of Inspection has been issued. It work is to be con- ce~ed due notice 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? 15513 Address........._.......h..h_......................_....._............................................._..__.n._.._.........................Date..._......____.._.._.........._......_......_h____... Ol7D.er.........___......____....__..._...___.._.____......_......_n_.................._.._..........._._.._..___._........_.._.Tenant..__.........................___......_______.__........_.......... wtringContractor..............._h__._________..._...n..__....._.______.__.._.__...._........._..__..____._n.........__.........________By..................______................................._.... NOTICE-Current must not be turned on until CertIfIcate ot Inspection has been issued. If work Is to be con. cealed due notice must be given the Inspector so that work may be inspected betore concealment. 1M Olympic Printers, Inc.