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HomeMy WebLinkAbout312 W 8th St - Building Electical Permit 312 W 8th St 13 - 300 cN ELECTRICAL PERMIT t A CITY OF PORT ANGELES c 360-417-4735 Application Number . . . . . 13-00000300 Date 3/29/13 Application pin number . . . 269300 Property Address . . . . . 312 W 8TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-2-6508-0000- Application type description ELECTRICAL ONLY on your excise tax form Subdivision Name . . . . . Property Use to the City of Port Angeles Property zoning . . . . . . . (Location Code 0502) Application valuation . . . . 0 ---------------------------------------------"------------------------------- Application desc 1-4 circuits ductless heat pump ---------------------- ----------------------------------------------------- Owner Contractor GREGORY P SCHERER JEFF NELSON ELECTRIC 20 CEDAR HILL LN 7062 OLD OLYMPIC HWY. SEQUIM WA 98382 PORT ANGELES WA 98362 (360) 477-0272 (369) 460-4291 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL --__oAdditional desc 1-4 CIRCUITS Permit Fee 75.00 Plan Check Fee .00 1 Issue Date . . . . 3/29/13 Valuation . . . . 0 Expiration Date . . 9/25/13 Qty Unit Charge Per Extension BASE FEE 75.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 75.00 75.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 75.00 75.00 .00 .00 QQ i INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN 1 13 FINAL Z] COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGE\BUILDING FROM FAX NO. :6814254 Mar. 27 2013 05:11PM P1 City of Port Angeles Permit Application-ElectricalPernmitResidentiaLpdf hnp://www.ci.port-ageles.wa.us/PDFs/Pere itsP]am ing/FlectricalPer. RECEIVED pORTA^, CITY OF PORT ANGELES PERMIT AMICATION MAR 2 Muilding Division/0ectrical Inspectioms 1' ELECTRICAL 321 East Fifth Street—P.O.Box 1150:Port Angeles Washington.98362 INSPECTIONS Ph: (360)417-4735 Fax: (360) 4 -4"11 Date: & 7 l3 Z10'8,2 Single Family Dwelling ReArN. Pow- Fm Plan Review Ma Be R ui ,Ple se mplete Electrical Plan Review Information Sheet O�q Job Address: Building Square Footage: IS-00 Descriptgn of above Owner Infonmatio Contractor( ormation Name: /(OCL 41 e;� 'C, NlaWng Address: ManiAddress: b (AT. State: Zip: CQty State:Q&Zrp: Phone: Fax: Ph Riled W11 Fax: L License#/Exp. License#I FjqX Item Unit Charge (int Total IQty Multiplied by Unit Chars,el Service/Feeder 200 Amp. $120.00 Service/Feeder 201-400 Arrp. $146.00 $ �_ Servioe/Feeder401-600AFT $205.00 $ �" Service/Feeder60140.00 Amp. $262.00 Service/Feeder over 1000 Amp. $373.00 Branch Circuit Wl Service Feeder $ 5.00 Branch Circuit WIO Service Feeder $ 63.00 $ ^_ Each Additional Branch Circuit $ 5.00 Branch Circuits 1-075.00 Temp.Sarvicel Feeder 200 Amp. Temp,SWce/Feeder 201400 Amp. $110.00 _ $ Temp.Service/Feedar 401-600 Amp. $149.00 Temp.ServicelFeeder 601-1000 Amp. $168.00 $ _ Porlal to Portal Hourly $ 96.00 Signal Circuit/Limited Energy-1&2 Family!)welling $ 64.00 $ - Manufactured Home Connection $120.00 $ Ranewable Electrical Energy-5KVA System or Less $102.D0 $ -_ Thermostat $ 56.00 _ $_ Note:$5.00 for each additional T-Stat NEW CONSTRUCTION Qy Y_ First 1300 Square R. $120.00 Each Additional 500 Square R.or Portion of $ 40,00 Each Outbuilding or Detached Garage $ 74.00 Each SWmning Pool or Hot Tub $110.00 $ Total Owner as defined by RCW.19.28.261:(1)Owner will occupy the structure for two years after this electrical pemit 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 maldng the electrical installation or alteration in compliance with the electrical laws,N.E.C.,RCW.Chapter 1928,WAC.Chapter 296-468,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 ele deal administrator: ❑ CIA ❑ char Q1 �.Q'Eroetcuarr � � t of l 1/')7/)AII Q•nt AW Building Permit 312 W 8th St 13 -2-94 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION �. 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 13-00000294 Date 3/27/13 Application pin number . . . 816810 Property Address . . . . . . 312 W STH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-2-6508-0000- REPORT SALES TAX Application type description RES MECHANICAL PERMIT Subdivision Name . . . . . . on your state excise tax form Property Use . . . . . . . Property Zoning . to the City of Port Angeles Application valuation . . 5898 (Location Code 0$02) -- - --------------------- Application desc DUCTLESS HEAT PUMP ---------------------------------------------------------------------------- Owner Contractor GREGORY P SCHERER PENINSULA HEAT INC 20 CEDAR HILL LN 782 KITCHEN-DICK RD SEQUIM WA 98382 SEQUIM WA 98382 (360) 477-0272 (360) 681-3333 ----------- Permit . . . . MECHANICAL PERMIT Additional desc DUCTLESS HEAT PUMP Permit Fee . . . . 64.80 Plan Check Fee .00 Issue Date 3/27/13 Valuation . . . . 0 Expiration Date 9/23/13 Qty Unit Charge Per Extension BASE FEE 50.00 1.00 14.8000 EA ME-FURN/HP/FAU c OR = 5 TON 14.80 ---------------------- Special Notes and Comments Per Washington State Code 51-51-315, installation of Carbon Monoxide detector(s) is required if you are installing or replacing a fuel burning appliance (wood, pellet, gas)and must be in place prior to the final inspection of this permit. They are required to be place directly outside of each sleeping area and at least one on each floor of the house. ------------------------------------------------ ------------------------- Fee summary Charged Paid Credited Due --- ---------- Permit Fee Total 64.80 64.80 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 64.80 64.80 .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 for a period of 180 days after the work has 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 a ulating constructionor a performance of construction. __f) Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Building Division/Building Permit V BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS- Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER,INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Footings Stemwall Foundation Drainage/Downspouts Piers Post Holes(Pole Bldgs.) PLUMBING: Under Floor/Slab Rough-In Water Line Meter to Bldg) Gas Line Back Flow/Water FINAL Date Accepted b AIR SEAL: Walls Ceiling FRAMING: Joists/Girders/Under Floor Shear Wall/Hold Downs Walls/Roof/Ceiling Drywall Interior Braced Panel Only) T-Bar INSULATION: Slab Wall/Floor/Ceiling MECHANICAL: Heat Pum /Furnace/FAU/Ducts- Rough-in uctsRou h-In Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES: Footing/Slab Blockinq&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parkin /Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE `- Inspection Type Date Accepted By v" 1 Electrical 417-4735 Construction- R.W. PW /Enc ineerin 417-4831 Fire 417-4653 -� Planning. 417-4750 Building 417-4815 T:Forms/Building Division/Building Permit BuildingPern itpdf http://www.cityofpa.us/PDFs/PennitsPlanTfing(BuildingPemfiLpdf ,A.CT ORT NGELES -- � CITY OF For City Use W . A S H I N G T O N , U . S. Permit# j -P -7 `'�'� Date Received: 3 321 East P Street Port Angeles,WA 98362 Date Approved '3-a-7-- t P. 360-417-4817 F: 360-417-4711 permits@cityofpa.us Building Permit Application Project Address: Main Contact: Phone #3t-d Ggt 333'3 an L a M E-Mail:*w ,♦4 s..k 1 e,.#-.e-ft Property Name Phone Owner G S`"�`�'�'r 3`n4/77 oZ7Z- MailingAd ess Email city state Zi$ Contractor N ♦ Phone Mailing Address Email city State Zip FS SC Z Contractor License# Expiration: Pev,i h �f 6 y p /o /` Project Value: Zoning: Tax Parcel# Lot# $ 5 `71r. Type of Residential Commercial ❑ Industrial ❑ Public ❑ Permit Demolition ❑ Fire ❑ Repair ❑ Reroof(tear off/lay over) ❑ For the following,fill out both pages of permit application: New Construction ❑ Remodel ❑ Addition ❑ Tenant Improvement ❑ Mechanical ,.�[PIumbing ❑ Other ❑ Misting Fire Sprinkler System? Maximum height of structure Proposed Bedrooms Proposed Bathrooms Yes D No D Project Description I have read and completed the application and know it to be true and correct:I am authorized to apply for this permit. I understand that it is my responsibility to determine what permits are required and to obtain permits prior to working on projects. I understand thatthe plan review fee is not refundable after plan review has occurred. I understand that I will forfeit the review fee if I cancel or withdraw the application before the permit is issued. I understand that if the permit is not issued within 180 days of receipt,the application will be considered abandoned and the fees forfeit. Date Print Name Signature 3/Z7//7/J 3 l�E h C eS'7`Na r i 1 of2 3/15/2013 10:19 AM 1)W alala�l 4llln{.1l41 aJ4�J/RA�►.41t�'Va1J4.aaJ/l V1 ala 4aaW aJf anannta�anuiaauaba.4a aaaa.rua. •, —> Residential Structures " For Office Use Area Description(SQ FT) Existing Proposed $$value Basement First Floor Second Floor Covered Deck/Porch/Entry Deck Garage Carport Other(describe) , Area Totals Commercial Structures 'For Office Use Area Descriptions(SQ FT) Existing Proposed $$Value Existing Structure(s) . Proposed Addition Tenant Improvement? Other work(describe) Area Totals Lot/Site Coverage Calculations Footprint(SQ.FT)of all Structures: Lot Size: %Lot Coverage SQ FT Site coverage(all impervious+ %Site Coverage structures Mechanical Fixtures Indicate how man of each a of fixture to be installed or relocated as part of this project. Air Handler Size: # Haz/Non-Haz Piping #of Outlets: Appliance Vent # Heater(Suspended,Floor;Recessed wall) # Boiler/Compressor Size; # Heating/Cooling appliance, # repair/alteration Evaporative Cooler(attached,not # Pellet Stove/Wood-burning/Gas # portable) Fireplace/Gas Stove Gas Cook Stove/Misc. Fuel Gas Piping #of Outlets: Ventilation Fan,single duct s # Furnace/Heat Pum / Size # Ventilation System # P �14 Forced Air Unit .• Z�• ! Plumbing Fixtures Indicate how many of each type of fixture to be installed or relocated Plumbing Traps # Fuel gas piping #of Outlets: Water Heater # Medical gas piping #of Outlets: Water Line # Vent piping # Sewer Line # Industrial waste pretreatment # interceptor Other(describe): T:\BUILDING\APPL1CA1n0N FORMS\BUILDING PERMrr 081212.DOCX 2 of 3/15/2013 10:19 AM PREPARED 4/05/13, 15:08:39 INSPECTION HISTORY REPORT PAGE 1 PROGRAM BP521L 0/00/00 THRU 0/00/00 CITY OF PORT ANGELES ----------------------------------------------------------------—- APPLICATION PROPERTY ADDRESS ASSESSOR PARCEL NUMBER ALTERNATE ID STRUCTR PERMIT INSPECTION RESULT DATE/STATUS INSPECTOR ------------------------------------------------------------------------------------------------------------------------------------ 13 .00000294 312 W 8TH ST 06-30-00-0-2-6508-0000- 063000026508 000 000 ME 00 MECHANICAL PERMIT ME99 0001 MECHANICAL FINAL 4/02/13 APPROVED JLL REQ COMM: April 1, 2013 3:00:04 PM pbarthol. REQ COMM: Chuck 681-3333 RES COMM: April 2, 2013 4:30:20 PM jlierly. Application Number . . . . . 08-00000008 Date 1/04/08 Application pin number . . . 665624 Property Address . . . . . . 312 W 8TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-2-6508-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ LIBERA, MIKE BOTERO & SON ELECTRICAL 316 POWER PLANT RD 940 TAMARACK WAY PORT ANGELES WA 98363 PORT ANGELES WA 98362 (360) 457-5662 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . . BOTERO/ 200A SVC Permit pin number . 118448 Permit Fee . . . . 64.00 Plan Check Fee .00 Issue Date . . . . 1/04/08 Valuation . . . . 0 Expiration Date . . 7/02/08 �N Qty Unit Charge Per Extension \ - 1.00 64.0000 ECH EL-R OR RM 0-200 ALT SRV FDR 64.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 64.00 64.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 64.00 64.00 .00 .00 SPECTION ELECTRICAL TYPE DATE: RESULTS : INSPECTOR: DEITCH 1/45 XT SERVICE OUCH - IN 47 FINAL COMMENTS : CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 321 EAST STH STREET. PORT ANGELES.WA 98.362 Application Number 06-00000745 Date 7/17/06 Application pin number 381300 Property Address 312 W 8TH ST ASSESSOR PARCEL NUMBER 06-30-00-0-2-6508-0000- Application type description ELECTRICAL ONLY Lasered Subdivision Name CED Property Use . Property Zoning . Application valuation 0 Owner Contractor ------------------------ ------------------------ LIBERA, MIKE SHAMP ELECTRICAL CONTRACTING 312 W 8TH ST PO BOX 383 PORT ANGELES WA 983625905 PORT ANGELES WA 98362 (360) 452-1689 ---------------------------------------------------------------------------- Permit . . ELECTRICAL NEW RESIDENTIAL Additional desc SHAMP/ REWIRE HOUSE Permit pin number 82297 Sub Contractor SHAMP ELECTRICAL CONTRACTING Permit Fee 78.70 Plan Check Fee 00 Issue Date 7/17/06 Valuation 0 Expiration Date 1/13/07 Qty Unit Charge Per Extension 1 00 78 7000 ECH EL-RM-0-200 1ST SRV FEEDER 78 70 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due 411v ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 78 70 78.70 .00 00 Plan Check Total 00 00 00 .00 y, Grand Total 78 70 78 70 00 .00 W Q1 COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPB DATE ACCBP'PBD CObWENTS YBS NO DITCH ROUGH-IN/COVER It-7-1,V-p SERVICE GENERAL COMMENTS: Pw.uat.1s 14%1 CITY OF PORT ANGELES. 15--8 FEL RECEIPT NUMBER DEPARTMENT OF LIGHT A PERMIT NUMBER APPLICATION AND ELECTRICAL PERMIT ® - TOTAL FEE �Q /,52. L - Y"-"P �/i r✓y CONT.LIC.NO. TIMETOCOMPLETE NO.STORIES LEGALOCCUPANCY ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT Site Address 3 1 ;2 w j h - ORR1E'CT ADSS IS RESPONSIBILITY OF APPLICANT PERMITS WITH WRONG ADDRE SES ARE CANCELLED _ Owner V I �� I I`7vg ll.t S Installation By - L�'f. n2 nI A1✓'S E ���•4 i Owner's Address 3 I moinstallers Address Z F3 L-L-7 Day Phone--- - Installers Phone Ll S 7 T-L $ 9. Application is hereby made for Permit to install Electrical Equipment as follows: 1.O © 14 ""-Jo Se ,z— i< 'Q _ wai Wiring Method p 4-Z NUMBER AMP 120V _ 240V NUMBER AMP 120V- 240V USE OF CIRCUIT CIRCUITS PER 1 0 1 00R FEE USE OF CIRCUIT - CIRCUITS PER 1 0 1 0OR FEE CIR 30 CIR 30 LIGHT SIGN LIGHT 50 VOLTS ` OR LESS CONVENIENCE MOTOR CONVENIENCE MOTOR - APPLIANCE _ - MOTOR DISHWASHER FIREALARMS DISPOSAL BURGLARALARM' , ® RANGEMISC. - OVEN y WATER HEATER LAUNDRY DRYER - REINSTALLATION LIGHT FIXTURE N " - FURNACE SUB TOTAL FEE GAS-OIL - - - - 'FURNACE ENERGYFEE ELECTRIC- BASIC FEE ELECTRIC HEAT 'TOTALFEE - - ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER A.C.UNIT AMP PHASE FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS SERVICEyy- A.W.G. SUB-TOTAL SIZE OF GROUND 19 SIZE OF ENTRANCE SWITCH b 6 I certify that the work to be performed under this permit will be done by the installer and in conformance with the N.E.C. Electrical Code. Date Application made �`� "�- �I ,195L(-- CONTRACTOR 95 LCONTRACTOR O OWNER(OR AUTHORIZED AGENT) Permission is hereby given to do the above described work,according to the conditions hereon and according the approved plans and specifications pertaining thereto, subject to compliance with the Ordinances f the City of Port Angeles. D CT OF. Y IGHT - Date Permit Issued By ® _ PLANS APPROVED 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 Inspector in Writing on Permit Placard. A. - Permits Phone: 457-0411 Ext. 158. WARNING PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK — SEE OVER— WHITE-Original CANARY-Duplicate PINK-Triplicate WHITE CARD-Inspector's Report OLYMPIC PRINTERS,INC. REPORT OF INSPECTOR DATEOFVIBIT YADEBY REMARKS Z 0 Q a ,O 4- 2� / fv �/K SLaJlG£ 2 4 x 2 W Lu F O Z O D ECTBERVICE s' FINAL O.N. aw ELECTRICAL WORK PERMITAPPLICATION e� ^ n Installation description Job wired by Electrical Contractor ❑ Owner ❑ Commercial ❑ Residential Electrical contractor name License number Date Expires i • ❑ New Altered/Addition e -8 Purchaser's mailing address `t Y0 =AQrrn A / t./f7yS/JA"Ci� City ,f State ZIP g T Telephone number FAX number Premises ow er's name j1i/2n L .�YZA Address of inspection 3 l 2-- CSX _ city hoe.% Ali,el,,;. LIZA Phone number to schedule inspection: Owner as defined by.RCW.19.28.2h1:(1) Owner will occupy the structure for two ),ears after this elect ical permit is finati2ed. (2) Owner is required to hire an electrical contractor if above.said property L for.sale, rent or lease. ❑ Cash ❑ Check# After reading the above statement, 1 hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical instal- LYCreditCard isa .Mastercard Discover lation 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 Card# Utility Specifications. Signature of owner, electrical contractor or electrical administratorlExpiration Date Inspection fee X Dater— f card $ OD Elec meal LoAd Additions and or subtractions Service Information ❑ NO LOAD CHANGES ❑ Baseboard _KW Voltage ❑ Furnace _KW ❑ Overhead Service Phase❑ 1 ❑ 3 ❑ Heat Pump _Ton LAR ❑ Temp Service Service Size: ❑ Fan-Wall _KW ❑ Underground Service Feeder Size: SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735 ROUGH-IN THERMOSTAT n Dae Appw,o]By Dam Approved By FINAL DITCH 3-�'�nage Approve)By EDme Approved By Inspection Area,Building or Equipment Ins ected Action Taken Electrical Date Inspector i 07/12/2006 13: 15 FAX 001/001 t u 1-7-- 1- n l r a ELECTRICALWORKPERMITAPPLICATION A Installation description Job wired by ❑Electrical Contractor ❑Owner ❑ Commerclal esidennat Fec(tical contractor name License number Date Expires O New O Altered/Additioa Purchaser's m liyg,eddress I 518 W � ci(y����� s18�31aZ 1"elephone number FA�umbe_ r .� ' 2 >Z� PreIp ses oy. is ""Ll r IYr•)P ra-) Address of inspec •o 2 + City Phone puptJygr„to se edu91 spection: (honer a.< defined by RCW./9.2 .26b(l) Owner will occupy the structure for two years after this electrical permit u ftnafeed. (2) Goner is required to hire an electrical contractor Y'above said properly is for sale, renr or lease. ❑Cash ❑ Check# After reading the abo,,e statement. I hereby certify that I am the owner of the above a nmed property or a licensed electrical contractor. 1 am making the electrical instal- ❑Credit Card Visa Mastercard Discover lotion 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 Card# Utility Specifications. Signature of owner, electrical contractor or electrical adminlstrator Expiration Date XDrI ofcard $nsgegtion fee ate: -1 Electrical Load Addition d or subtractions Service Information O NO LOAD CHANGESY-v � n 7 O Baseboard _KW Voltage Voltage D Furnace _KW ❑ Overhead Service Phase O 1 O 3 O Meat Pump _Ton_LAR ❑ Temp Service Service Size: O Fan-Wall _KW O Underground Service Feeder Size: SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735 ta 5AI,1­1 TAT SERVICE Aypra•cd By FTEDER ➢Y Date ADDNVrd B. Inspection Date Area.Building or Equipment inspected Action Taken Electrical Inspector