HomeMy WebLinkAbout1011 W 12th St - Building
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" CITY OF,PORT ANGELES
'DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
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FEE RECEIPT NUMBER
PERMIT NUMBER
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.... TOTAL FEE /6 e"P .-- .. -
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CONT. Lie. NO. TIME TO COMPLETE NO. STORIES LEGAL OCCUPANCY
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ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Site Address - / 0 / ! fA-! /2. P,
CORRECT ADDRESS IS RESpbNSIBllITY OF APPLICANT
ownert11lf.O[5E,V . .
Owner's Address
PERMITS WITH WRONG ~DD1sses AREt:ANCELLE~ ( -L '.
Installation By --/:U!i f t1. r __ ~ c..J.Y1, {C
Installers Address ." .-
Day Phone Installers Phone
Appljcation is here_by made for Permit to i~stall Electri~al Equip.ment as f QWS:
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Wiring Method
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NUMBER AMP 120V 240V NUMBER AMP 120V 240V
USE OF CIRCUIT CIRCUITS PER 10 100R FEE . USE OF CIRCUIT CIRCUITS PER 10 ,00A FEE
CIR 30 CIR 30
LIGHT SIGN
LIGHT 50 VOLTS'
OR LESS
CONVENIENCE . -. - - MOTOR - _.
CONVENIENCE - MOTOR -
APPLIANCE - - MOTOR
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DISHWASHER , FIRE,ALARMS . -
DISPOSAL BURGLAR ALARM
RANGE MISC.
OVEN
WATER HEATER
LAUNDRY - . - ,. .. -
DRYER REINSTALLATION LIGHT FIXTURE #
FURNACE - . SUB TOTAL FEE .
GAS - OIL
FURNACE ENERGY FEE
ELECTRIC -
BASIC FEE
ELECTRIC HEAT
, TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
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A.C. UNIT AMP PHASE.
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
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SERVICE A.W.G.
1- SUB. TOTAL . . --
SIZE OF GROUND SIZE OF ENTRANCE SWITCH
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Date Permit Issued
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.. . CONTRACTOR OR OWNER (OR AUTHORIZED AGENT)
permission is hereby given to de;> th ~bove des~~ibed work, accqrdJng to the conditions hereon and according to the approved plans and
specifications pertaining thereto, subject to compliance with the Ordinances ,of th Cit ,0tPort Angeles.
- - . , -. .-DIREC ORf80F. ,TV I HT . '
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otify ep"artment of City Ught by Street Address and Permit'N~~ber when ready for inspectIon. Work must not
b~ covered or_ curr~nt turned on before Insp'ectlon and O.K. for covering or service has been given by Inspector in
Writing on Permit Placard. A.' Permits Phone: 457.0411 Ext. 158.
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under this permit will be done by the installer and in conformance with the N.E.C. Electrical Code.
Date Application made
,19
WARNING
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER -
WHITE. Original CANARY. Duplicate PINK, Triplicate WHITE CARD . Inspector's Report
OLYMPICPRINTERS.INC.
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DATE OF VISIT
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REPORTOF INSPECTOR
MADE BY
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REMARKS
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O.K. TO CONNECT SERVICE
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CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
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15206
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Port Angeles, Washington_moo, __.:-::____________:______mmmm__m____m_m' 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 granted to do ,ctriCal work as listed below.
Address ___1r;:.l/____0!..I__2:_0_:..mm___m__m_m___m_________________ Occupancy__..!._g__~______________________________..
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Owner hn_!.-:u.!__':..J:...;'~n_~~_';~:.~~.:!:.~~..L!..:;__1'__~w_~n_____~~________~____ Tenant__n____~.n~.~...._.___....___h___n~_____uU_.___h__..__..~n_~_____
Wiring ~~ntractor h____L.(_~~~~~.~__:~:.C..~:m~m~_~~._L~_:__~:~.~~~~m~m_ By .hh___~________~__~~nm___mm.__.__~___~__~nm~~~m____.U_+
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Light Outletsm..._.....m...mmm~m...........
Receptacle Outlets.um.._mmnnmn.......
Service, volts .nmm..nnnnm..m".nnnm
No. wires .n.nn.nu.n......n..nnn.nnn
Dryer, KWi _____________m_______.______
Size wiresmnn..nmm.........nmmn...
Range, KW mum
Main fuse mm..n......mmnnn........m
Water Heater:
Enclosure ........n...mmnnnnnmm....
Type of wiring:
Entrance Cable nn..mmmm.......m.
Heat~:~-:::::;2:~?r;:h:::--:-
Motors: size, volts and phase:
Rigid Conduit nmmm...
Metallic Tubing nm__,"""m"nmnn
Current transformers:
No. & Sizemmmm......mmmnnn..nn
Ser. NO..................n_..nn..__nnnnn___..
Ser. NO......._........n.nn.nnn................
Ser. NO..nn_nn.__nnnn....nn.............n..
Total Loadm...........mm_....n..
Type of Wiring:
Armored Cable m...
Non-Metallic ........m._.....n.m....mn
Knob & Tubem
Rigid Conduit __.mm__m__.__....____..._
Metallic Tubing mmm..m..m..mm
Raceway ..n
Circuits, LighLm
Utility nn'm",,'
Heat
Range ....m......mm
Water Heater nn...nnnmmnm...nn
Motor ._..................._.......................
Dryer..nun....nnnnnn..nunn.....n......._
Furnace .....mm.mn....m.'_.__
Remarks:
Ser. No. nn..nnn...........n.......nnnnu... Total ............_nnn._n..n......._..n
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----------t.--,-,---'------'-m!:.'--'::---------OT--"'.-~__,~_~_"__!___L!.---'--~,-,,---------::..--h----c"--.'--oooc:--L,1.p.~"-':.(.!:1----~~ t
___~~____~__~_~_~~~__.__.__.._.._._____.___._____~~_h._~__~~_~~~__~~~__~_~..~_~________...._~._____~______._.._________~_~~__~__~__~..._.__._.__.~__._~~___~~_._.___._.._.._._.
_________000__000___000____000.._000_000____000____________________________.000__000000_-000-----------.-------------;---/--------------;---------------/000----------------
Permit Fee Treas. Receipt ')/;' . ", /
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$_______________....__________________. No.___________________________ By ooo_______L._________:___.___,_______,~:::_:.,_"'.:.__,______________
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
N?
15206
Date called for inspection.........................._........................__.........._........_....................................................._...___............._.........._..__........__....
Preliminary inspection dates............................... .....--......-............._..............___......................_............................._hn...............___...................
Total Load ......................................._..................._......._...
Inspectioncompleted..._.._.............._.........................................'...n.n..nnu...._..n_nn..nu....u.nn...nn......._hn.._......_...nnu........._..........___..n...
1M 3-72 Olympic Printers, Inc.
..._.nnun.................u.n..........n.............n.nnnnn.........n._h____._......_......_