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HomeMy WebLinkAbout2311 S Francis St - Building Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 08-00001239 Date 10/01/08 608841 2311 S FRANCIS ST 06-30-10-5-1-0900-0000- ELECTRICAL ONLY RESIDENTIAL MEDIUM DEN STY o Application desc Washer dryer circuits Owner Contractor HOUSING AUTHORITY OF CLALLAM 2603 S FRANCIS ST PORT ANGELES WA 983626710 ANGELES ELECTRIC 524 E. 1ST ST. PORT ANGELES (360) 452-9264 WA 98362 N VJ Permit ELECTRICAL ALTER COMMERCIAL Additional desc Permit pin number 135467 Permit Fee 58.00 Plan Check Fee Issue Date 10/01/08 Valuation Expiration Date 3/30/09 .00 o ~ ---- Qty 1. 00 Unit Charge Per 58.0000 ECH EL-COMM ALT <5 CIRCUITS Extension 58.00 \r Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 58.00 58.00 .00 .00 plan Check Total .00 .00 .00 .00 Grand Total 58.00 58.00 .00 .00 \ ~ 17 ? r ~ \r .) ~ .-.... SPECTION ELECTRICAL TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE OUGH - IN FINAL OMMENTS: 09/26/2008 12:15 FAX 360 452 9265 08-lZ-39 5",,, $; g, , , \!'iOi~~! AR1!C2fVE D ANGELES ElECTRIC, INC. 524 EAST FIRST PQRT ANGELES, WA 98362 ~ 0001/0001 S E P 2tI.2Em'RICAL WORK PERMIT APPLICATION . Job wired by Electrical Contractor DOwner description Commercial l:I Residential ~" ~Addition Electrical contractor name License number Date Expires Purchaser's mailing address ANuEu::s t:LtCTRIC, INC. 524 EAST FIRST PORT~6hi~, WA 98362 t41dD /{Nb City Telephone number FAX number ~ OrflM Premises ~ name , , srzrt:r Address or iD~ection ("'t 2r~ I ....) · City E ..~ f1"Pr. Phone num er to schedule lDspec:tlon: F/2+uus Sr' ~-K'9ib Owner as defined by RCW19,28,26J"(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, After reading the above statement, 1 hereby certify that 1 am the owner of the above named property or a licensed electrical contractor, I am making the electrical instal- lation or alteration in compliance with the electrical laws, N,E.C., RCW. Chapter 19,28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and Utility Specifications. Signature of wner, electrical contra CJ.c~ Check # ~edjt Card VlSa rd f6f'-. W~tlUL ~ h~4J/L.. ~ REC~ r:; SEP 26 2008 ~ ~DEPT. Mastercard Discover Card# _____~/\l_-ft'~ -____ x Expiration Date of card l:I NO LOAD CHANGES l:I Baseboard _ KW l:I Furnace KW l:I Heat Pump _ Ton _ LAR l:I Fan-Wall KW l:I Overhead Service l:I Temp Service l:I Underground Service SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735 ROUGH-IN THERMOSTAT JZ/~!/re ~ By F1NAL ~ ~By Dale APJl'OVod By DITCH Dale APJl'Oved By Service Information Voltage Ij.~ Phase IIir'f lJ 3 Service Size: -fIII--, Feeder Size: ~ z... SERVICE Date Approved By FEEDER Dale Approved By Inspection Area, Building or Equipment Inspected Action Taken Electrical Date Inspector I I .~ 1) ii;;" l\~{t :/~..'~ ,., , , , " 'I.. ,;. ';,.' ..',' Af],' _. .i ,C( j\"[ ~. J..... .}~ f, 4{1. ("",.~(., "Ii ~ J ." (/\'? *6\ ~\L\ 2, '-\ Official Use Only Assem.# Backflow Assembly Test Report City of Port Angeles Public Works and Utilities Department Water/Wastewater Collection Division Re~eiwd NAME OF PREMISES; ,1-) /1 II AI 7 II AI,; [ L e,)' - 1-/ C /J /1 . v - . SERVICE ADDRESS; ~ j/ I f iff /14C IS S 1 j( tt~ ;- , LOCA TION OF DEVICE: I AI/I. A Y (; /'? () 1/ AI /) r Ft ;? C // f .> t S '( AJ J? I Ii' /,/ :.,- f( /) j/b t. }/I..t. I, I 5~/J('E. J-/(1t73rsS' Serial No, ASSEMBL Y: ~ Manufacturer Model Size IS THIS AN APPROVED ASSEMBL Y? YES 4J,.-NO 0 IS ASSEMBL Y INSTALLED CORRECTL Y? YES ~"'rGO 0 DATE OF INSTALLATION i '). I ... (; '7 UNKNOWNO REDUCED PRESSURE PRINCIPLE ASSEMBLY DOUBLE CHECK VAL VE ASSEMBLY RP 0 DC 19/ PVB 0 SVB 0 RPDA 0 DCDA 0 Air Gap 0 AVB 0 CHECK VALVE#I CHECK VALVE #2 RELIEF VALVE PVB/SVB Initial Leaked 0 Leaked ij]/' Did Not Open 0 AIR INLET Test Held at U psi Closed Tight 0 Held at ~ psi Did Nol Open 0 Opened at _ psi Opened al _ psi Repairs Cleaned 1i:J/ Cleaned 0/ Cleaned 0 CHECK VALVE Leaked 0 Held al _ pSt Replaced 0 Replaced 0 Replaced 0 REPAIRS Cleaned 0 Details Replaced 0 3 psi Buffer YES 0 NO 0 Test Held al :J.. <t psi Closed Tight 0 Held al L-1- psi Opened al _ psi AIR INLET Opened al _ psi CHECK VALVE Held ai_psI BACK PRESSURE NO 0 YES 0 Final AIR GAP INSPECTION: REQUIRED MINIMUM SEPARATION: YES 0 NO 0 l T,YPE OF.HA'L;ARD c..A vz,,' A ( ",;:P~' .;t- . Line Pressure J? psi COMMENTS J --....-...- ] AI r jJ /- C"I t:.f) Il r 7? (I Ji IJ ~ - ~ c-l t,.}Jlt 1/ -{ t:. f ('p J J ..j' A firr? nAFt ."- /'/) / t.- 't /J . i'A AI r,(j?!/ Held Backpressure YES 0 NO 0 #2 Shutoff Held YESD NO 0 Relief Valve Exercised YES 0 NO 0 Date/Time Tester Signature Cert # Test Kil Passed Failed Initial Test J f - 11~ b 7 f.).pf J-;'Cf IC,StcJ:.t,f? -? ,J1>r'I~ ,,'~l ~ "" /1 jl2..?-tl~,..., IJ?-'It/ Y ;tlll?/AI' t >~7 o lE---- Repairs })/II';: fA Atf't.KJJ o o Final Test R ,r t (Ie: r:../C "'1:h. J R ," ? - Ah; V'" j; ;rt~t If At! If) t.1/Etf I [1..-- o " WHITE - CUSTOMER COpy YELLOW. PURVEYOR COPY PINK - TESTER COpy CITY OF PORT ANGELES Attn: Building Permit Technician 321 E. Fifth St., Port Angeles, WA 98362 (360) 417-4815 fax (360) 417-4711 ~ PctV;c;( Cowavr Applicant or Agent S~I1{'OYJ. Tyv; t:/c{{,'O"1,-LJ//C. Owner 1-1- ..e adS tt vi- ../ I Owner's Address z:J I' )". Fya Y\ C i.> S -1-. Contractor/Engineer rJ a Vi 0< Co w &< VI Contractor/Engineer's Address {. Ot go)C "2 2 'f ( License # SA N FO II rq I L F BUILDING PERMIT APPLICA TION Print in ink For City Use Only: Date Received \2-- \ 2....07. Permit # () '1/' 1'19..\.\ Date Approved Phone Phone Phone (3cq - f~2.- 1/76' I S~{{;- 14.,'''1 , /?'A. C(? 3 f:z. , Expires (J 6' //2 I Z 0 C)~ f I PROJECT ADDRESS 2. sf Parcel Number Lot Zoning Project Tvpe & Brief Description: Check all that apply )<New Construction o Addition o Remodel o Repair oRe-roof o Demolition o Sign o Industrial o Heat System o Other o wall-mounted 0 projecting 0 freestanding 0 awning Total si n area s . ft. Maximum allowed si n area s . ft. o Heat pump 0 wood-burning stove 0 gas fireplace 0 pellet stove 0 other o other Floor Areas Existinq (SQ. ft.) Proposed (SQ. ft.) Basement @$ per sq. ft. = $ 151 Floor 2nd Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other TOTAL VALUATION $ -r-OO. O(J Total footprint of structures sq. ft. Lot size sq. ft. = Lot coverage % Max. height of proposed structures ft. Occupancy group # of bedrooms Will a lawn sprinkler system be installed? '-e f Occupant load # of full baths Will a fire sprinkler system be installed? ~ Construction type # of half baths I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to working on projects. 0 . J i1' II /' - . .. Date {'2..j /'Z../07 Print Name Ii. V, (J... C (J tV /J..11 Signature J/ ~ ~ T:Forms/Building Division/Bldg Permit Appl.-2006 Code.doc ,..~. Pos 0 Shall not be r ous place. - uilding Official. \ ROUTING SLIP Certificate of Occupancy i !J' Certificate/Inspection Fee DATE 8. 13. D3 Address of Proposed Bus.iness .2 311 5. FrCl. nCl5 51::.. Applicant Q~ CAP / H b . A njeJec) Address Do 80 y.. c-?q,-~o .:5eQUirnj lAJA Phone: business562-31o, ~~'52-BLjq(o New Business ............................ Transfer of Business location. . . . . . . . . . . . . . . . Change of Ownership . . . . . . . . . . . . . . . . . . . . . . New Building .................. . . . . . . . . . . . Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Temporary Business ... . . . . . . . . . . . . . . . . . . . . Change of Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . ;< legal Description: lot Current Use of Property: Zoning Classification of Property: WILL THERE BE ANY OF THE FOLLOWING? Construction changes. . . . . . . . . . . . . . . . . . . . . . . . . . . Electrical changes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mechanical (heating, cooling, stoves) . . . . . . . . . . . . . . Plumbing changes ............................. New or relocated signs. . . . . . . . . . . . . . . . . . . . . . . . . . New septic tanks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New sewer service ............................. Admission charged to patrons. . . . . . . . . . . . . . . . . . . . Is this a home occupation? ...................... Excavation ot tilling ot lots ....................... Work done in City right-ot-way . . . . . . . . . . . . . . . . . . . . Is there sufficient off-street parking? . . . . . . . . . . . . . . . New driveway openings. . . . . . . . . . . . . . . . . . . . . . . . . A grading plan tor site drainage. . . . . . . . . . . . . . . . . . . (parking lots, downspouts, etc.) .................. Are the existing streets paved? .. . . . . . . . . . . . . . . . . . Are there existing sidewalks? . . . . . . . . . . . . . . . . . . . . . Is there curb and gutter? ........................ Other........................................ . YES NO -~ -)( -- -~ )( -+- -~ -~ .l5.- - _-L- -~ -~ ~- -~ _-L -~ ~- ~- ;X. -- _1- I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the information I have supplied is correct to the best of my knowledge. Building Section Public Works Department Planning Department Fire Department City Clerk P.B.I.A. ~}~~~p~~H A REJECTED ~~ ~ ~d ~~t ~. /9-0< -gQ LVe5 THE FOllOWING Will BE REQUIRED: PERMITS 1) Building 2) Plumbing 3) Electrical 4) Mechanical 5) Sewer 6) Sidewalk installation 7) Driveway installation 8) Curb installation 9) Sidewalk obstruction 10) Water meter installation 11) Fire 12) Occupancy 13) Sign 14) Shoreline 15) Home occupation 16) Conditional use 17) Other BUSINESS LICENSE 1) Taxi 2) Peddlers 3) 2nd Hand Dealer 4) Pawn Broker 5) Dance 6) Hotel - Motel 7) Fireworks 8) Ambulance 9) Tattoo shop 10) Other F \eMe.. (lcLLL pY \ Or'" tD I (\-spec..t\oY) - ree-C io dA~o.b)e.. <A.\~ y n, Sf5teVY) ""-. CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 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 07-00001484 Date 12/12/07 062184 2311 S FRANCIS ST 06-30-10-5-1-0900-0000- HEAD START PLUMBING REPAIR RESIDENTIAL MEDIUM DEN STY 500 Owner Contractor HOUSING AUTHORITY OF CLALLAM 2603 S FRANCIS ST PORT ANGELES WA 983626710 SANFORD IRRIGATION PO BOX 2246 SEQUIM WA 98382 (360) 683-9807 Permit PLUMBING PERMIT Additional desc IRRIG. DBLE-CHK BACKFLOW Permit pin number 117622 Permit Fee 57.00 Plan Check Fee .00 Issue Date 12/12/07 Valuation 500 Expiration Date 6/09/08 Qty Unit Charge Per Extension BASE FEE 50.00 1. 00 7.0000 ECH PL- EA LAWN BACKFLOW 7.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 57.00 57.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 57.00 57.00 .00 .00 0? ~ ?~~ ~ V "- O~ 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 12//2/07 . tail;} CowaJ1 ; Print Name Signature of Contractor or Authorized Agent ECW-;; ~ Signature of Owner (if owner is builder) T:Forms/Building Divisiou/Building Permit (1010 1/07).wpd BUILDING PERMIT INSPECTION RECORD . CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. It IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE . INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. 3. I - .L (Xl -C INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS SHEAR WALLS / WALLS FOUNDATION DRAINAGE / DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLU~'lUING UNDER FLOOR / SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL. 1< B DATE 1-2 -68 ACCEPTED BY: BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR W ALL/HOLD DOWNS WALLS / ROOF / CEILING DR YW ALL (INTERIOR BRACED PANEL ONL Y) T-BAR \ INSULA nON SLAB WALL / FLOOR / CEILING MECHANICAL HEA T PUMP / FURNACE / DUCTS GAS LINE WOOD STOVE / PELLET / CHIMNEY FINAL DATE ACCEPTED BY: COMMERCIAL HOOD / DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT II's SEPA: PARI<ING/L1GHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMM~:RCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT.. 4 I 7-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING t'J vJ -. \j) ~ :s (1 -j VI cq2 \JJ S. ~ o C T:Forms/Building Division/Building Permit (J % 1/07).wpd '" ROUTING SLIP ~ cYb'" ~o1 Certificate of Occupancy . Certificate/Inspection Fee DATE 8. 13- 03 Address of Proposed Bus.iness .2 3 I , 5. F~a.. nCI5 S -t . Applicant c9~ tAP/Hi. An~e<; View Head Address CO 80 'f. ~q,-I)o 5eQUt t'Y\ I lAJA _ Phone: business 562- 3'10'" ~ j'52 -B Ljq~ New Business ...... ..................... ( ;<. ) Transfer of Business location. . . . . . . . . . . . . . .. ( ) Change of Ownership . . . . . . . . . . . . . . . . . . . . .. ( ) New Building ....... . . . . . . . . . . . . . . . . . . . . .. ( ) Remodel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ( ) Temporary Business . . . . . . . . . . . . . . . . . . . . . .. ( ) Change of Use. . . . . . . . . . . . . . . . . . . . . . . . . . .. ( ) legal Description: lot Current Use of Property: Zoning Classification of Property: WILL THERE BE ANY OF THE FOLLOWING? Construction changes .... Electrical changes. . Mechanical (heating, cooling, stoves) . . Plumbing changes .. New or relocated signs. .. New septic tanks. . . New sewer service .. . Admission charged to patrons Is this a home occupation? ... Excavation of filling of lots . ..... . .. Work done In City right-of-way ... Is there sufficient off-street parking? .. New driveway openings A grading plan for site drainage (parking lots, downspouts, etc.) Are the eXisting streets paved? Are there eXisting sidewalks? . Is there curb and gutter? Other. . . . YES NO _-1L ,( -- -~ l( -~ -~ -~ -A-- _-A- -~ _-L ~- -~ -~ -~ ~- ~- )< -- _1- I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the information I have supplied is correct to the best of my knowledge. ~~;r;~ REJECTED Building Section Public Works Department Planning Department Fire Department City Clerk P.B.I.A. ~9i LaI~ THE FOllOWING Will BE REQUIRED: N PERMITS BUSINESS LICENSE W 1) BUilding 1) TaxI 2) Plumbing 2) Peddlers 3) Electrical 3) 2nd Hand Dealer 4) Mechanical 4) Pawn Broker 5) Sewer 5) Dance 6) Sidewalk Installation 6) Hotel - Motel 7) Driveway installation 7) Fireworks 8) Curb installation 8) Ambulance '\ 9) Sidewalk obstruction 9) Tattoo shop S-\ 10) Water meter installation 10) Other ~ 11) Fire .,. , 12) Occupancy F \eMe. Q.o..LL \fl 13) Sign 14) Shoreline Pyio(' tD 15) Home occupation i nSpel.-tlCf1 - r-ee-d 16) Conditional use -to ci\ooh)e. Q\c;\..Y r., 17) Other sy~+eVY) Comments / Conditions t!.C- ~-~~.~-j- ~PT~ ~~,.A~ .<:lS.5; aJVlflC IJD \ Pas a Shall not be r ous place. uilding Official. . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 ELECTRICAL PERMIT Site Address: PERMIT NO. S's75 //2 'I/re.. DATE ~31 o READY FOR INSPECTION License Number: o WI LL CALL FOR INSPECTION Phone: Installed By: Owner/Business: OwnerfBusiness Address: ELECTRIC HEAT o BASEBOARD KW _ o FURNACE KW o HEAT PUMP KW_ o FAN/WALL KW _ o RESIDENTIAL IW COMMERCIAL o NEW CONSTRUCTION ~ REMODEL !;/'l ADD/ALTER CIRCUITS o SERVICE UPGRADE/REPAIR o TEMPORARY SERVICE DetailslDescription: .J::Y'c -kfit'lY, f( -4vtdcL Phone: Sq. Ft. o RISER 'fl OVERHEAD SERVICE o UNDERGROUN)'l S~RVICE VOLTAGE: I i!f? ~ ~1 ~ 03 ~ SERVICE SIZE Z6V FEEDER SIZE AMPS AMPS . W.S. No. SERVICE SIZE CAPACITY: o O.K. 0 NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o OVERHEAD SERVICE APPROVED o CHANGE SERVICE WIRE o OTHER Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report or on the BuilglA9 Permit. PHONE 457-0411, EXT. 224. /j t91Jv\ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT , $ Electrical Inspector Installer: New Meters . WHITE - File by address PINK - Top: Eng, Bottom, Customer OLYII.mc PRINTERS INC .s.:: t,3D Permit Fee GREEN - Top: Meter Dept., Bottom: City Hall . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 ELECTRICAL PERMIT Site Address: - Installed By: Owner/Business: Owner/Business Address: o RESIDENTIAL o COMMERCIAL o BASEBOARD KW _ o FURNACE KW _ o FAN/WALL KW o HEAT PUMP KW_ o SIGN o TEMPORARY SERVICE o PERMANENT SERVICE o NEW CONSTRUCTION o REMODEL o ADD/ALTER CIRCUITS o SERVICE UPGRADE/REPAIR ~ SPECIAL EQUIPMENT (LIST BELOW) Detai Is/ Descri ption: PERMIT NO. '7'l/S-S / /s/9~ , , DATE o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Phone: Sq. Ft. o OVERHEAD SERVICE o UNDERGROUND SERVICE VOLTAGE: o SINGLE PHASE o THREE PHASE SERVICE SIZE AMPS i' I E",{;/- At"/- . L/o I {" / ;g &4'1 t:/!)' U-t('-A/ / W.S. No. SERVICE SIZE CAPACITY: o O.K. NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o CHANGE SERVICE WIRE o OTHE,R .' o Ditch Inspection O.K. o Rough-in/cover O.K. o O.K. to connect service ,-V~inal O.K. Site Address: Installer: ~ ,;;2.3/ G4J-1.t~ "lCl.a./ New Meters V' Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work m st not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report or on the Buil~mit. PHONE 457-0411, EXT. 224. ,8; tiC) ~ m/l/1 NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ r ~O -- Efectricallnspector Permit Fee WHITE - File by address YELLOW - file by number PINK - Top: Eng, Bottom, Customer OLYMf'IC PRINTERS INC GREEN - Top: Meter Dept., Bottom: City Hall . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 Site Address:.;:2 31/ Installed By: ~, ELECTRICAL PERMIT .~ PERMIT NO. fl38r DATE /~//O,/? 3 Owner/Business: , o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Phone: Owner/Business Address: Sq. Ft. o RESIDENTIAL "IS( COMMERCIAL .10' BASEBOARD KW _ o FURNACE KW _ o FAN/WALL KW _ o HEAT PUMP KW ~ o SIGN o TEMPORARY SERVICE o PERMANENT SERVICE o NEW CONSTRUCTION o REMODEL o ADD/ALTER CIRCUITS o SERVICE UPGRADE/REPAIR o SPECIAL EQUIPMENT (LIST BELOW) ~OVERHEAD SERVICE o UNDERG~U~S~lliCE VOLTAGE: tl. C;Z (f ~ SINGLE PHAS~ o THREE PHASE SERVICE SIZE ;:J.Pf) AMPS Details/Description: Iflo/alM C IflS5 ~(Jt41. ~~ c9~~ . W.S. No. SERVICE SIZE CAPACITY: o O.K. NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o CHANGE SERVICE WIRE o OTHER o Ditch Inspection O.K. o Rough-in/cover O.K. o O.K. to connect service o Final O.K. Site Address: .6)3// So. ..-.-- . r~ . Instailer: [la~ '5 Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report or on the Buildin ermi!. PHONE 457-0411, EXT. 224. ~ 30- NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ Permit Fee WHITE - File by address YELLOW - file by number PINK - Top: Eng, Bottom, Customer GREEN - Top: MeIer Dept., Bottom: City Hall OLYMPIC PAINTERS INC.