HomeMy WebLinkAbout126 1/2 W 2nd St - Building
~~ I~ CITY OF PORT ANGELES
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FEE RECEIPT NUMBER DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
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.CONT.L1e. NO: T,rME TO C9MPLETE NO. STORIES
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PERMIT NUMBER
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LEGAL OCCUPANCY
ELECTRICAL PERMIT ONLY' ,NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Site Address. / .;) U 15 w e:sr Q) hi .. , . ,
, -COAAECT ADDRESS IS RESPONSIBILITY OF APPLICANT PERMITS WITH WRONG ADDRESSES ARE CANCELLED
Owner Gey.,/[)" 6. MAI'\9,.\1\O .' Installation By Ge...~ID G. M-A~
Owner's Address ~ ...,' 1~1 (" w~ ,...::)~ Installers Address
Day Phone ',I., 7 - 8 J 9.1 "" "1~si~lIers Phon~\ \' \ '-
Application is hereby mad~ for Permit to install Electrical Equipment as follows:
c.h"''\5'e SeyV;oce.. .. R"IN~r<l...
WirJng Method
P IOP~cf'/V'M't3
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NUMBER AMP 120V 240V NUMBER AMP 120V 24QV
USE OF CIRCUIT CIRCUITS PER '0 100A FEE USE OF CIRCUIT CIRCUITS PER '0 100R FEE
CIR 30 CIR 30
LIGHT SIGN
LIGHT . , - - .50VOtTS
OR LESS
CONVENIENCE .- - MOTOR
CONVENIENCE - . MOTOR
APPLIANCE . MOTOR
DISHWASHE~ - FIRE ALARMS
DISPOSAL BURGLAR ALARM
RANGE MISC.
-
OVEN
WATER HEATER
LAUNDRY ,
DRYER . . REINSTALLATION LIGHT FIXTURE #
FURNACE - SUB TOTAL FEE
GAS.. ole
FURNACE ENERGY FEE
.ELECTRIC -
BASIC FEE
ELECTRIC HEAT --- - ~O '0
TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
-
A.C. UNIT AMP PHASE
FEEDER ... '" ~ SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE Y ~~t;) // 3(1,('),.( AW.G.
. I SUB. TOTAL ?~. 00
SIZE OF GROUND SIZE OF ENTRANCE SWITCH
.
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 3 - ;ll -If - -). ; .19 1"r BY" :J!:I~ W ~..-tN.-/
CONTRACTOR OR OWNER (0; AU;H-OiJ~ ;G~NT)
Permission is hereby given to do the above described work, according to the conditions hereon and according to the approved plans and
specifIcations pertaining thereto, subject to compliance~he Ordinances of the City of Port Angeles. . .
If - /-..1'-~..5 . lldlDIRr~FC~.J'~'JG~T . -
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Date Permit Issued :y f '(t- y
~ . ~lANS APPRO EO ...... .. . ~
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 gi\len by Inspector in
Writing on Permit Placard. A.. Permits Phone: 457-0411 Ext. 158.
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER -
WARNING
WHITE - OrIgInal CANARY. Duplicate PINK. Triplicate WHITE CARD -Inspector's Report
1'"\1 VUPlf"; PRINTERS_INC.
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DATE OF VISIT
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REPORT OF INSPECTOR
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REMARKS
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TU~N ON WATER 0 Date
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NAME
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/2' -fi. t(hST :;21\10
ADDRESS
ACCT. NUMBER
DEPOSIT .
Mailing Address AMOUNT
The Undecs;gned he<eby make, appHcation to the City of Po,t Angele, for UtiHty Semce ,ubject to the ter"" and condiUo",
of appHcable City Ormnance, which are he<eby agreed to and .~re made a part of thi, appHcation.
NEW APPLICANTS:
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EMPLOYER ADDRESS
Ai reR('O 5(?/fVI(~ ;f('('CN-v'pcT
3" J rt' '7lH 3'
PHONE NO.
iff 7 - r ) 8"},
OWN
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RENT
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PREVIOUS RESIDENCE
PROPERTY OWNERS NAME
SIGNATURE X
AD Y TAT
APPLICANT ACKNOWLEDGES RECEIPT OF A COpy OF "CITY OF PORT ANGELES. GeNERAL
INfORMATION RESIDENTIAL UTILITY SERVICE".
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O.K. FOR C?YERING
'". \ OJ~. TO CONN,EIC.i'~~VICE
FINAL-O.K.
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