HomeMy WebLinkAbout2612 W 10th St - Building
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TOTAL FEE
," , CITY OF PORT ANGELES,
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
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PERMIT NUMBER
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CONT. Lie. NO,
NO. STORIES
LEGAL OCCUPANCY
T1ME:TO COMPL.ETE
ELECTRICAL PERMIT ONLY 'NO OCCUPANCY OR 'USE ESTABLISHED UNDER THIS PERMIT
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De-: ~~R.b~'1rss IS RESPONSIBI~ITY OF APP;L1CANT
Owner's Address' <(-10 f. .:f'tt;o ur. - .
Day Phone "\J\,,^ ~ F l j\JJ !) '\.it S" ~
Application is hereby made for Permit to install Electrical Equipment as follows:
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NUMBER AMP~~20V, 240V
g.fPI:'f .~.^ 100R
CIRC~ CIR '7./ 30
Site Address
Owner
USE OF CIRCUIT
LIGHT
LIGHT
CONVENIENCE
CONVENIENCE
APPLIANCE
DISHWASHER
DISPOSAL
.' RANGE
OVEN
WATER HEATER IV
LAUNDRY ,
DRYER
FURNACE
GAS - Oil
FURNACE
ELECTRIC
ELECTRIC HEAT
ELECTRIC HEAT
A.C. UNIT
FEEDER
SERVICE
:. . PERMITS \:yITH W~ONG
Installation By
Instalie(s Add;ess
Installers Phone
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Wiring Method
FEE"
NUMBER
CIRCUITS
AMP
PER
CIR
FEE
240V
100R
30
120V.
10
USE OF CIRCUIT
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, \:~ Jj)REALARMS
~ IV- \. \./; """!lGLAR ALARM
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REINST~T~HT FIXTURE #
SUB "T~ FEE
ENERGVYEE
BASIC FEE
SIGN
SO VOLTS
OR LESS
MOTOR
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MOTOR
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TOTAL FEE
SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
AMP
SIZE OF SERVICE ENTRANCE CONDUCTORS
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PHASE
A.W.G.
I SUB- TOTAL
SIZE OF GROUND
SIZE OF ENTRANCE SWITCH
Date Application made
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.
By
CONTRACTOR OR OWNER (OR AUTHORIZED'AGENT)
Permissi9n i~ hereby given to do the above described work, according to the conditions hereon an9 according to the approved plans and
specifications pertaining t,h:e(tO"1SUbje(ct; c;mPliance With the O'p:LYA,nNance of t~e City Ofl~r'ID'T LIGHT \ \ '.:....
Date Permit Issued r ''fJ 16
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. fqr cov~ring or service has been given 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 -
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WARNING
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WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
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DATE OF VISIT
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MADE BY
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REPORT OF INSPECTOR
REMARKS
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O.K. TO CONNEC! SERVICE
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