HomeMy WebLinkAbout4106 Fairmount Ave - Building
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FETECEIPT NUMBER
CITY OF PORT ANGELES ..
DEPARTMENT OF LIGHT
. APPLICATION AND ELECTRICAL PERMIT
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PERMIT NUMBER
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. TOTAL FEE .. .
I CO NT. lie. NO. TIMETOCOMPLETE NO. STORIES LEGAL OCCUPANC..v
I ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Site Address 4r 0 ~ F-A-111.... MA u I-J + .Ail [, ,
I CORRECT ADDR/55 IS RESPONSIBILITY OF APPLICANT PERMITS WITH WRONG ADDRESSES ARE CANCELLED
Owne;. M l ~ i.. G:, ~ s VI O/-Jj. . . Installation By S .r I. ~
Owner's Address Installers Address
Day.phbne 1)' 2.-. - (;:1 Z- 'Z..-- .. Installers Phone .
A~PlicJ.tion is hereby made for Permit to. install Electrical Equipment_as f91lows~
I '/J<;I..'/ ';;t.eu(().. 10 MO l?1! l.
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Wiring Metho~
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I NUMBER AMP 120V 240V NUMBER AMJ:' 120V 240V
'USE OF CIRCUIT CIRCUITS PER 10 100R FEE USE OF CIRCUIT CIRCUITS PER 10 100A FEE
I CIR 30 CIR 30
L1GHf SIGN
LIGHT . 50 VOLTS .. ..
OR LESS
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CONVENIENCE MOTOR :
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CONVENIENCE .^ MOTOR
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APPLIANCE A iAA MOTOR
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, I / /, , .i'IRE ALARMS
'DlSHWASHER . - . .-
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DISP9SAL /V BURGLAR ALARM
.. . ..
, MISC.
RANGE
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OVEN I
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WATER HEATER 74- It:: t/'V
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LAUNDRY' .. . --
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DRY~R REINSTALLATION LIGHT FIXTURE #
FURNACE . SUB TO.TAL FEE ..
GAS ~ OIL
FURNACE ENERGY FEE
ELEC)"RIC . .
ELECTRIC HEAT BASIC FEE
. I. TOTAL FEE .
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
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A.C.WNIT AMP PHASE
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FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
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SERVICE AW.G.
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I SUB. TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH
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I certif>, 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.
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Date Application made ~ 'lJo' 1"'/- ',19 By
I- . . I -.. . _. ~ _, ~~NTRACTOR'OR OWNER (OR AUTHORIZED AGENT) .
Permi.ssion 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 with the Ordinances of, t City. of Port Angeles.
I .. " 01 TOR OF .
Date Permit Issued 0 If j.
I Noti Department of City light by Street Address and Permit ,Number, when ready for inspection. Work must not
be overed or current turfled on before inspection and:O.K: for covering or service has been given by Inspector in
I WAI'RNING W ting on Permit Placard. A.' Permits Phone: 457.0411 Ex\. 158.
L...:1 PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER -
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WHITE - Original
CANARY. Ouplicate
PINK. Triplicate
WHITE CARD. Inspector's Report
REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
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T;( 2.- ~ TfiJ,; /~ \<:; O.K. TO CONNECT SERVICE
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