HomeMy WebLinkAbout221 W 5th St - Building
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FEE RECEIPT NUMBEA
CITY 0" PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
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PEAMIT NUMBER
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'. CaNT. LIC. NO. TIME TO COMPLETE -NO. STORIES LEGAL OCCUPANCY
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Site Address ZZ/ ,W SiI!! ';Sir " -,
" CORRECT ADDRESS IS RESPONSIBILITY OF APPLICANT PERMITS WITH WRONG ~DDRESSES ARE CANCELLED . _ '..~'
Owner .TJi~~' c.~ll1~ ' InstallationB; 't.9I--I,...,P;c EL~crnc.-
Owner'sAddr~s'" l-~I ,'n' . Installers Address &01 ;>i?, I-/fVCOI-AI ';;;"
Day Phone t.{~1':" t.t-'4l--'" h Installers Phone ' '1-($7 - S.sOJ,
Application is hereby made for Permit to insta!! Electrical Equipment as fo'llows: ,et5 - .s E..evi t:.1.! IEx':>-ri oJ tG.
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Wiring Method
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NUMBER AMP 240V NUMBER AMP 120V 240V
USE OF CIRCUIT PEA 120V 100R FEE USE OF CIRCUIT PEA 100A FEE
CIRCUITS CIA 10 30 CIRCUITS CIA 10 30
LIGHT SIGN
,liGHT - 50 VOLTS
OR lESS
CONVENIENCE MOTOR
CONVENIENCE MOTOR
APPLIANCE . -. MOTOR -.
DISHWASHER FIRE AlAR_MS .
DISPOSAL BURGLAR ALARM
RANGE MISC.
'OVEN
WATER HEATER
lAUNDRY
. ( REINSTAllATION LIGHT FIXTURE # .. -.
DRYER
FURNACE SUB TOTAL FEE
.GAS .. OIL
FURNACE ENERGY FEE
ELECTRIC BASIC FEE
ELECTRIC HEAT ;If ;3 f) tft7
TOTAL FEE -
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER,
A.C. UNIT ken AMP 51 A;G~c PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE '-/10 AW.G.
I SUB-TOTAL SIZE OF GROUND #- L./ SIZE OF ENTRANCE SWITCH ~OV
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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
j{)-/7-
,19 ~ 'I
By
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Date Permit Issued
CONTRACTOR OR OWNER (OR AUTHORIZED AGENT)
Permission is hereby given tq do the above described work, according to the conditions hereon and according to.the approved plans and
specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles:
\ DIRECTOR OF CITY LIGHT
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~ PLA 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
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REPORT OF IN~PECTOR
DATE OF VISIT
MADE BY
REMARKS
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O.K. FOR COVERING
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O.K. TO CONNECT SERVICE
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FINAL O.K:
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