HomeMy WebLinkAbout634 Georgiana St - Building
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CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
000330A
PERMIT NUMBER'
FEE RE ;EIPT NUMBER
TO.
30. e.o .'?-I'!-t) 1- 1'0t' y ~ ~ II r9 ;vi e..
r AL FEE
CONT. Lie. NO. TlMETO COMPLETE NO. STORIES LEGAL OCCUPANCY
ELECTRICAL, PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
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CORAECT ADDRESS IS RESPONSIBILITY OF APPLICANT
Owner_((;rl-l/Y!llk.?Tul.. ;(K'
Site Address
Owner's Address
PERMITS WITH WRONG ADDRESSES ARE CANCELLED
Installation By fj,'4l-C" tftjCt 7/<'/(. jC-;.c.
Installers Address IJ.O 60'i- ')7 /1i'}j)tO( j.
'-/.57 - u t",
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Day Phor.e Installers Phone
Applicati In is hereby made for Permit to install Electrical Equipment as follows: (; p
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Wiring Method
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NUMBER AMP 120V 240V NUMBER AMP 120V 24DV
USE )F CIRCUIT CIRCUITS PER 10 100R FEE USE OF CIRCUIT CIRCUITS PER 10 100R FEE
CIR 30 CIR 30
LIGHT SIGN
LIGHT 50 VOLTS
OR LESS
CONVE \IIENCE I f...'" V 6('e. ~ MOTOR
CONVE "HENCE MOTOR
APPLlp \lCE MOTOR
-
DISH,^, ..SHEA FIRE ALARMS
OISPO~ AL BURGLAR ALARM
RANGE MISC_
OVEN
WATEF HEATER
LAUN[ =lY
ORYEF REINSTALLATION LIGHT FIXTURE #
FURN,c :::E SUB TOTAL FEE
GAS- :>IL
FURN,c :::E ENERGY FEE
~;~IC ~ BASIC FEE
ELECT ~IC HEAT v- t/ 7/(uJ 3t', <9'-'
-- TOTAL FEE
ELECT ~IC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
--
A.C. U' lIT AMP PHASE
--
FEEDE'~ SIZE OF SERVICE ENTRANCE CONDUCTORS
SEAvrc E V- Jeo t~ (./'" r6?~ A.W.G
I SUB.TOTAL "0. <>'" SIZE OF GROUND SIZE OF ENTRANCE SWITCH
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.
f. ).7 .19:5'";- By-....---/r /(
ctrical Code.
Date Application made
CONTRACTOR OR OWNER (OR A THORIZED AGENT)
Permission 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 the City of Port Angeles.
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Oat P .t I d By 4lr ~
e erml ssue PLANS AP ROVED
C ~ 'I 7 .- S' ,) Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not
r be covered or current turned on before inspection and O.K. for covering or service has been given by Inspector in
I 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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REMARKS
MADE BY
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The undersigned hereby makes application to the City of Port Angeles for Utility Service subject to the terms and conditions
of applicable City Ordinances which are hereby agreed to and are made a part of this application.
NEW APPLICANTS:'
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PREVIOUS RESIDENCE
ADDRESS CITY STATE
APPLICANT ACKNOWLEDGES RECEIPT OF A COPY OF "CITY OF PORT ANGELES. GF:NERAL
INFORMATION RESIDENTIAL UTILITY SERVICE",
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SIGNATUREY
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