HomeMy WebLinkAbout538 W 4th St - BuildingElectrical Permit
538W4 th St
12-1194
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number . . . . .
12-00001194 Date
9/12/12
Application pin number . . .
177594
DITCH
Property Address . . . . . .
538 W 4TH ST
ASSESSOR PARCEL NUMBER:
06 -30 -00 -0 -0 -8440 -0000 -
Application type description
ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
FINAL
Property Zoning . . . . . . .
RS7 RESDNTL SINGLE FAMILY
Application valuation . . . .
0
----------------------------------------------------------------------------
Application desc
200 amp service change
----------------------------------------------------------------------------
Owner
Contractor
------------------------
BAKER, DEBORAH ANN
------------------------
JEDI ELECTRIC
538 W 4TH ST
331 FORS RD.
PORT ANGELES WA 98362
PORT ANGELES
WA 98362
(360) 460-0556
----------------------------------------------------------------------------
Permit ELECTRICAL
ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 120.00
Plan Check Fee..
.00
Issue Date . . . . 9/12/12
Valuation . . . .
0
Expiration Date , . 3/11/13
Qty Unit Charge Per
Extension
1.00 120.0000 ECH EL -0-200
SRV FEEDER
120.00
----------------------------------------------------------------------------
Fee summary Charged
Paid Credited
Due
Permit Fee Total 120.00
120.00 .00
.00
Plan Check Total .00
.00 .00
.00
Grand Total 120.00
120.00 .00
.00
cam,
REPORT SALES TAX
on your excise tax form'
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
IZ Z
ROUGH -IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION -
Signature of owner or Electrical Contractor X Date:
G:\EXCHANGE\BUILDING
�1
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362
Ph: (360) 417-4735 Fax: (360) 417-4711
Date: Cl _A9 — I oZ
(�i 2 Single Family Dwelling
* Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 53P tJ e.c -F
Building Square Footage:
Description of above foo o v,-; Se r/i`(-e C i -Aa K* Z.
Owner Information
Name: D(-.h'k;k; .�_e
Mailing Address: S3k we_ST it rI"
City:17 State: LJc Zip: a
Phone: Fax:
License # / EXD.
Item
Unit Charge
Service/Feeder 200 Amp.
$120.00
Service/Feeder 201-400 Amp.
$146.00
Service/Feeder 401-600 Amp
$ 205.00
Service/Feeder 601-1000 Amp.
$ 262.00
Service/Feeder over 1000 Amp.
$ 373.00
Branch Circuit W/ Service Feeder
$ 5.00
Branch Circuit W/O Service Feeder
$ 63.00
Each Additional Branch Circuit
$ 5.00
Branch Circuits 1-4
$ 75.00
Temp. Service/ Feeder 200 Amp.
$ 93.00
Temp, Service/Feeder 201-400 Amp.
$110.00
Temp. Service/Feeder 401-600 Amp.
$149.00
Temp. Service/Feeder 601-1000 Amp .
$168.00
Portal to Portal Hourly
$ 96.00
Signal Circuit/ Limited Energy -1 & 2 Family Dwelling
$ 64.00
Manufactured Home Connection
$120.00
Renewable Electrical Energy - 5KVA System or Less
$102.00
Thermostat
$ 56.00
Note: $5.00 for each additional T-Stat
NEW CONSTRUCTION ONLY:
First 1300 Square Ft.
$120.00
Each Additional 500 Square Ft. or Portion of
$ 40.00
Each Outbuilding or Detached Garage
$ 74.00
Each Swimming Pool or Hot Tub
$110.00
Contractor Information
Name: �EA7 Lj
eC i r IG
Mailing Address: 33r Fere
2rt
City: f1 State:
t,Jc-\ Zip: c'S-363
Phone: Fax:
License # I Exp. Scle
` 1�5 7 C Z
Qty Total (Qty Multiplied by Unit Charge)
$-12,!2 --Total
Owner as defined by ROW, 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., ROW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port
Angeles Municipal Codg arpd Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Signature of owner, ctrical contractor or electrical administrator: ❑ cash check S01i-1
❑ Credit Card #
_._ // _ /�.- Dated: ` —/C- t� 0110112012
PREPARED 3/07/11 9 25 52 INSPECTION TICKET PAGE 7
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/07/11
ADDRESS 538 W 4TH ST SUBDIV
TENANT NBR GLENN P BAKER
CONTRACTOR AIR FLO HEATING CO INC PHONE (360) 683 3901
OWNER GLENN P BAKER PHONE (360) 452 9407
PARCEL 06 30 00 0 0 8440 0000
APPL NUMBER 10 00001073 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
ME99 01 3/07 11 J MECHANICAL FINAL TIME 01 00
March 4 2011 4 32 53 PM 1pangrle
SALLY 452 9407 (I CALLED HER TO FINAL THIS PERMIT )
MECHANICAL FINAL HEAT PUMP
AFTERNOON
COMMENTS AND NOTES
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Ductless heat pump
ELECTRICAL PERMIT
CITY OF PORT ANGELES de
360-417-473
10 00001318 Date 11/10/10
891508 REPORT STATE SALES TAX
538 W 4TH ST
06 30 00 0 0 8440 0000 on your excise tax form
ELECTRICAL ONLY to the City of Port Angeles
(Location Code 0502)
RS7 RESDNTL SINGLE FAMILY
0
Owner
Contractor
RESULTS
INSPECTOR.
GLENN P BAKER
CASCADE ELECTRIC
PO BOX 2383
PO BOX369
FORKS
WA 983312383
PORT HADLOCK
WA 98339
(360) 452 9407
(360) 531 0385
Permit
ELECTRICAL HEATPUMP
\ \ ,�
Additional desc
v \
Permit pin number
177170
Permit Fee
73 50
Plan Check Fee
00
r
Issue Date
11/10/10
Valuation
0
Expiration Date
5/09/11
Qty Unit Charge
Per
Extension
1 00 73
5000 ECH EL BRANCH CIRCUIT WO/FEEDER
73 50
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
73 50
73 50 00
00
Plan Check Total
00
00 00
00
Grand Total
73 50
73 50 00
00
INSPECTION TYPE
DATE.
RESULTS
INSPECTOR.
DITCH
SERVICE
ROUGH IN
FINAL
yl
COMMENTS
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
c
Signature of owner or Electrical Contractor X Date.
Nov 08 10 07 57a Robert Nordberg 3603799043
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections ELECTRICAL
321 East Fifth Street — P O. Box 1150 / Port Angeles Washington, 983625PECTIONS
Ph (360) 417-4735 Fax (360) 417-4711
Date: 1 g D
1 & Single Family Dwelling _ Multi -Family or Commercial" _ Commercial Addition I Alteration 1 Remodel I Repair'
' Plan Review Ma Be Required Ple Com9tete Electrical Plan Review Information Sheet
Job Address. _.r7 R !!!V� �� S T
Building Square Footage:
Description of above V10 �-ft�t�s�_ti� UI,V
Owner InformatioLr
% Ake
Contra for Info ion
e
Name: _
Name: CQSC4 cl
Mating /Ndr ss: 5 3V
Mailinc due 'V
City. State: L4/ -*t zip.
City l' St;
Phone: Fax:
License # ! Exp.
Phone: Fa
License # i Exp.
�3t
Item
Unit Charge
QtV T
Service/Feeder 200 Amp.
$119.90
Service/Feeder 201-400 Amp.
$145.50
Service/Feeder 401-600 Amp
$ 204.60
Service/Feeder 601 1000 Amp.
$ 262.20
Service/Feeder over 100D Amp
$ 372.50
Branch Circuit WI Service Feeder
$ 2.60
Branch Circuit W/O Service Feeder
$ 73.50
Each Additional Branch Circuit
$ 2.60
Temp Servicel Feeder 200 Amp.
$ 92.70
Temp. ServicelFeeder 201-400 Amp.
$110.30
Temp ServicelFeeder 401-600 Amp.
$14870
Temp. ServicerFeeder601 1000 Amp
$167.90
Portal to Portal Hourly
$ 9590
Sign/Outline Lighting
$ 88.20
Signal Circuit/ Limited Energy I First 1500 sf — Commercial
$ 95.90
Note: $5.00 for each additional 1500 sf
Signal Circuit/ Limited Energy 1 & 2 Family Dwelling
$ 63.90
_
Signal Circuit/ Limited Energy Multi -Family Dwelling
$ 63.90
Manufactured Home Connection
$ 119.90
Renewable Electrical Energy 5KVA System or Less
$102.30
Thermostat
$ 56.00
NEW CONSTRUCTION ONLY.
Iet..1-0-., e.
First 1300 Square Fl. $ 110.30 S
Each Additional 500 Square Ft. or Portion of $ 35.20 S
Each Outbuilding or Detached Garage $ 73.50 S
Each Swimming Pool or Hot Tub $11030 S
E Total - 5 (]
Owner as defined by RCW 19.28.261 (1) Owner will occupy the structure for two years after this electrical perm' s -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, KE C RCW Chapter 19.28 WAC. Chapter 29646B The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14 05 050 regarding Electrical Permit Applications
Signature of owner electrical contractoy or electrical administrator, t3 Cash D Check
A A -Credit
X Dated: �� 6 01A112010
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
INSTALL A DUCTLESS HEAT PUMP
Owner
10 00001073 Date 9/24/10
266485
538 W 4TH ST
06 30 00 0 0 8440 0000
GLENN P BAKER
MECHANICAL APPL PERMIT
RS7 RESDNTL SINGLE FAMILY
3901
Contractor
GLENN P BAKER
AIR FLO HEATING CO INC
PO BOX 2383
221 W CEDAR
FORKS
WA 983312383
SEQUIM WA 98382
(360) 452 9407
(360) 683 3901
Permit
MECHANICAL PERMIT
Additional desc
INSTALL A DUCTLESS HEAT PUMP
Permit pin number
174086
Permit Fee
64 80
Plan Check Fee 00
Issue Date
9/24/10
valuation 0
Expiration Date
3/23/11
Qty Unit Charge Per
1 00
Fee summary
BASE FEE
14 8000 EA ME FURN/HP/FAU < OR = 5 TON
Permit Fee Total
Plan Check Total
Grand Total
Extension
50 00
14 80
Charged Paid Credited Due
64 80 64 80 00 00
00 00 00 00
64 80 64 80 00 00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
�(IAIPq
,5,q, � �
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 regulating construction or the performance of
construction. _
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T Forms/Building Division/Building Permit
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
-7
Date
Accepted By
Landscaping
Comments
FOUNDATION
Construction R W PW I Engineering 417-4831
Footings
Stemwall
Foundation Drainage / Downspouts
Piers
Planning 417-4750
Post Holes (Pole Bldgs.)
PLUMBING
FINAL
Date Accepted b
Under Floor/ Slab
Rough -In
Water Line Meter to Bldg)
Gas Line
Back Flow / Water
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.
FINAL
i
Date Accepted b J
Heat Pum / Furnace / FAU / Ducts
Rough -In
Gas Line
Wood Stove / Pellet / Chimney�'1
Commercial Hood / Ducts
MANUFACTURED HOMES
Footing / Slab
Blocking & Hold Downs
Skirting
PLANNING DEPT Separate Permit #s
SEPA.
ESA.
Parkin / Lighting
]SHORELINE.
Landscaping
FINAL INSPECTIONS REQUIRED PRIOR
TO OCCUPANCY/ USE
Inspection Type
Date
Accepted By
Electrical 417-4735
Construction R W PW I Engineering 417-4831
Fire 417-4653
Planning 417-4750
Building 417-4815
T Forms/Building Division/Building Permit
�-g
QQ
00
E
St
C
BUILDING PERMIT APPLICATION Print in ink
f
10 � '-CITY OF PORT ANGELES
,- Attn. Building Permit Technician
�— 321 E Fifth St. Port Angeles, WA 98362
(360) 417-4815 fax (360) 417-4711
,1( QwhW ff &ocn)kj Websiie, (3 le h n P Oc Ke -) P o Box Z 38'x, f6 H<,r w q 83 1 Z3J
Applicant or Agent __kk QLD E Phone
Owner " 7EhKP__f1L Phone
Owner's Address Lk
_ S I>,-eT IpoRr kap E
Contractor/Engineer R t!& P -UW 14 N'[- t N &— Phone
Contractor/Engineer's Address a. W CEb�R- S� SEQUA
License # Expire.
PROJECT ADDRESS
Parcel Number
Project Type & Brief Description.
Check all Mal apply
o New Construction
o Addition
❑ Remodel
❑ Repair
o Re -roof
❑ Demolition
For City Use Only -
Date Received -Z?r 10
Permit # I d-) 0-13
Date Approved
*b (o
�SiE
lei
Lot Zoning
V(Residential o Commercial o Multi -family o Industrial
o Sign ❑ wall -mounted o projecting ❑ freestanding
Total sign area sq. ft. Maximum allowed si+
❑ Heat System K Heat pump ❑ wood -burning stove o gas fireplace ❑ p
❑ Other
Floor Areas
Basement
1" Floor
2"d Floor
3`d Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Total footprint of structures
Existing (sg. ft. l Proposed ($1 ft.)
Max. height of proposed structures
Will a lawn sprinkler system be installed?
Nill a fire sprinkler system be installed?
o awning ❑ other
area sq ft.
it stove ❑ other
per sq ft. = $
TOTAL VALUATION .S
01 ro
s
sq ft. - Lot size sq ft. = Lot coverage
_ ft. Occupancy group # of bedrooms
Occupant load # of full baths
Construction type # of half baths
have read and completed this application and know it to be true and correct. l a horized to apply for this permit and
inderstand that it is my responsibility to determine what permits are required, a o obtai permits prior to working on
)rojec E ����
)ate t Print Name AtNY�R.S -Signature
;Forms/B ildinglimsiontaldg Permit Appl —2006 Code.doc
I Cl 1L66 689 096 071A N I d WuLt, 6 0102 22 das
Clallam County Assessor & Treasurer - Property Details - 56238 GLENN P BAKER for Page 1 of 5
Clallam County Assessor & Treasurer
Property Search Results > 56238 GLENN P BAKER for Year 2010 - 2011
Property
Account
538 W FOURTH STmm
Property ID-
56238
Legal Description.
Geographic ID-
0630000084400000 Agent Code.
Type.
Real
Name.
Tax Area:
0010
PA 121 PORT ST CNTY H2 L Land Use Code
Open Space
N
DFL
Historic Property-
N
Remodel Property -
Multi -Family Redevelopment: N
ST SCH STATE SCHOOL
Township-
$13574
Section
Range
$13574
`2010
Location
CC -GEN COUNTY J
$72.24
Address.
538 W FOURTH STmm
PORT ANGELES WA
Neighborhood-
Cycle 5 Res
Neighborhood CD-
10955130
Owner
Name.
GLENN P BAKER
Mailing Address:
PO BOX 2383
FORKS WA 98331 2383
Taxes and Assessment Details
Property Tax Information as of 09/24/2010
�Mapsco
Map ID- 2
LT 10 EXC S 50' BL 84
11
N
Owner ID-
% Ownership
Exemptions:
12219
100 0000000000%
Amount Due if Paid on NOTE If you plan to submit payment on a future date make sure you enter the
click RECALCULATE to obtain the correct total amount due
http.//vpn.clallam.net:8084/propertyaccess/Property.aspx?cid=0&year=2010&prop_id=56 9/24/2010
First ISecondl
_
__
Half
Half
jI
1 Year Statement ID I Taxing Jurisdiction _
-
Base
Amt.
Base
Amt. Penalty j Interest I Base Paid p
201_0
39288
ST SCH STATE SCHOOL
$135.74
$13574
$000
$000
$13574
`2010
39288
CC -GEN COUNTY J
$72.24
$72.23
$000
$000
$72.24
2010
39288
PORT PORT _
$1016
$1015
$000
$000
$1016
2010
39288
PORT ANG PORT ANGELES
$167.24
$167.25
$000
$000
$167.24
# 2010
39288
SD #121 SCHOOL DISTRICT #121
$17581
$17582
$000
$000
w $17581
2010
39288
NTH OLY LIB NORTH OLYMPIC LIBRARY
$2099
$2099
$0 00
$000
$2099
i2010
39288
�-
HOSP #2 HOSPITAL #2
$2964
$2963
$000
$000
$2964
2010
39288
WSMET PK DIST WILLIAM SHORE MET PARK DIST
$943
$943
$000
$000
$943
2010
39288
CITY—STORMWATER CITY STORMWATER
$3600
$36 00
$0 00
$0 00
$36 00
2010
39288
WEED_CONTROL WEED CONTROL _
$0 82
$0 81
$0 00
$0_00
$082
2010 39288 TOTAL.
$65_8.07
$658.05
$0.00
$0.00
$658.0_7
2009
562382008
ST SCH STATE SCHOOL
$15551
$1 55 51
$000
$000
$311 02
2009_562382008
CC -GEN _COUNTY
__
$7870
-
78 71
$000
$000
$157_41
2009
562382008
PORT PORT
_$11 15
$11 15
$000
$000
$22.30
2009
562382008
PORT ANG PORT ANGELES
$172.62
$172.63v
$000
$000
$345.25
2009
562_382008
SD #121 SCHOOL DISTRICT #121
$192.31
$1_92.31
$000
$000
$38462
2009
562382008
NTH OLY LIB NORTH OLYMPIC LIBRARY
$22.87
$22 87
$000
$000
$4574
http.//vpn.clallam.net:8084/propertyaccess/Property.aspx?cid=0&year=2010&prop_id=56 9/24/2010
CITY OF PORT ANGELES
LIGHT DEPARTMENT ELECTRICAL PERMIT 'N'° 16532
Port Angeles, Washington ...._.....�K—C;7r; - -----------I 19
In accordance with the City Ordinance to regulate the installation, extension, or repair of elec-
trical equipment in, on, or about any building or other structure in the City of Port Angeles, per-
mission is hereby
2granted to d�o/el ctrical work as listed below.
Address ...... J- � Ci%- l� Occupancy_ ?� -------- ------------------
Owner% ? - Tenant ---------------------- ---------- ----------------- ----------------------
�}i--
Wiring Contractor V:.F t0- :�--------------/- �Bvy�--Y---------------------------------------------------- -------------
fv20 la
Light Outl
Receptacle
Dryer, KN
Range, Kw ----------- _.._.-------.._------- ----
Water Heater:
KW ...
Heat: KN....f...!.'
Motors: size, volts and phase:
Total Load .............................
Remarks:
Service, volts
'
No. wires ........
Size wires....�.
n
..
Main fuse----.l.."',a
�...p..._a,(...........
/T ..............
Enclosure .......
Type of wiring:"
15
...............
Entrance Cable
.............................
Rigid Conduit -----------------
Metallic Tubing ...........................
Current transformers:
No. & Size .......................................
Ser. No.. ............................................
SecNo.` .............................................
Ser. No ..............................................
t
• Type of Wiring:
Armored Cable .............................
Non -Metallic .................................
Knob & Tube ................................ -
Rigid Conduit ........................ _....
Metallic Tubing ...........................
Raceway ....................... ____
Circuits, Light .......................................
Utility............... ....... _....................
Heat-------------------------- ------------ _...---
Range.............................................
Water Heater ...............................
Motor..._ ........................................
Dryer.............................................. --
Furnace ............... ...................
Total
Permit Fee Tress. Receipt /
$ --------------- -------- ----- No ............................. By
NOTICE—Current must not be turned on until Certificate of Inspection has been Issued. If work Is to be con.
cealed due notice must be given the Inspector so that work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
u�
Address
Owner
ELECTRICAL PERMIT
N° 16532
............................... By ..............................................................
rent must not be turned on until Certificate of InsDectfon has been issued. It work is to be con -
must be given the Inspector so that work may beinspected before concealment.
iM Olympic Printers, Inc. b
CITY OF PORT ANGELES
LIGHT DEPARTMENT ELECTRICAL PERMIT NV 16528
Port Angeles, Washington......-- f_ •= ---------------------_--- 192 G7_
In accordance with the City Ordinance to regulate the installation, extension, or repair of elec-
trical equipment in, on, or about any building or other structure in the City of Port Angeles, per-
mission is hereby granted to do electrIC14 work as listed below.
5 3 bc%'' X
Address------------------------------------- ---------- ---------------------------- Occupancy......, — ---------
---------------
Wiring Contractor
LightOutlets ............................... .... .....
Receptacle Outlets ...............................
Dryer, KW ..........................................
Range, KW ------------------------------------------
Water Heater:
KW ............ . . .
Heat: KW.... ... -`�--- -....................
Motors: size, volts d phase:
Total
Remarks:
Permit Fee
$'.:---�C-o-:K2_ By-----P------
Service, volts _/;24 ��.. ..
No. wires ........ ~�/�.................`f, ..
Size wires../..'4't:.../._..
Main fuse ......f "l.,............
Enclosure .......t
Type of wiring:
Entrance Cable
Rigid Conduit ...............................
Metallic Tubing ...........................
Current transformers:
No. & Size .......................................
Ser. No ..............................................
Ser. No.
Ser. No.
Ser.
Treas. Receipt
Type of Wiring:
Armored Cable .............................
Non -Metallic .................................
Knob & Tube............ ....... ...... __....
Rigid Conduit ........................... _..
Metallic Tubing ...........................
Raceway
Circuits. Light .................................
Utility--------------- __.... ....................
Heat....._................_.............._.._--
Range.............................................
Water Heater ...............................
Motor..............................................
Dryer................................................
Furnace ............................................
Total
$----------------- --- ------------- No ............................. BY // .....
NOTICE --Current must not be turned on until Certificate of Inspection has been issued. If work Is to be con.
cealed due notice must be given the inspector so that work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
Address
Owner
N° 16528
WiringContractor................................... ......... !............. ........................... .................................... By..............................................................
NOTICE --Current must not be turned on untIPCertlflcate of Inspection has been Issued. If work is to be con-
-ccealed due notice must be given the Inspector so that\work may be Inspected before concealment.
1M Olympic Printers, Inc.