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Home My WebLink About636 Georgiana St - BuildingApplication Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Owner RUBLE R 636 GEORGIANA ST PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date WA 983623324 60 65 3/08/06 9/04/06 Signatl{fe bf Contractor qt Authorized Agent T:\Policies \1102_15 building permit inspection record05.wpd 1/4/2005) CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 06 00000229 465187 636 GEORGIANA ST 06 30 00 5 1 4000 0000 MECHANICAL PERMIT RS7 RESDNTL SINGLE FAMILY 3288 MECHANICAL PERMIT FREE STANDING LP STOVE 72389 Contractor PA SWIMMING HOLE 518 W 8TH ST PORT ANGELES (360) 565 1163 Plan Check Fee Valuation Permit Fee Total 60 65 60 65 00 Plan Check Total 00 00 00 Grand Total 60 65 60 65 00 Date Date 3/08/06 FIREPLACE S WA 98362 00 00 00 00 0 Qty Unit Charge Per Extension BASE FEE 50 00 1 00 10 6500 ECH ME -GAS PIPE 1 TO 5 10 65 Fee summary Charged Paid Credited Due 1 °re4 G r 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 as 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 constfuctior. Signature of Owner (if owner is builder) Date 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 UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES 1 NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL/HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP FURNACE DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY COMMERCIAL HOOD DUCTS MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #'s PARKING/LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT CONSTRUCTION RW PW/ ENGINEERING 417 -4807 FIRE 417 -4653 I BUILDING PERMIT INSPECTION RECORD I 1 3) 1 IoC 1 1 1 I 1 417 -4735 ELECTRICAL LIGHT DEPT PLANNING DEPT 417 -4750 BUILDIG 417-4815 b i(PI I t r l T•\Policies \1102_15 building permit inspection record05.wpd [1/4/20651 FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES 1 NO I FINAL FINAL SEPA. ESA. SHORELINE: CONSTRUCTION RW PW ENGINEERING I FIRE DEPT I PLANNING DEPT BUILDING DATE ACCEPTED BY. DATE ACCEPTED BY. PREPARED 3/09/06 12 33 09 INSPECTION TICKET PAGE 8 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 3/09/06 ADDRESS 636 GEORGIANA ST SUBDIV CONTRACTOR PA SWIMMING HOLE FIREPLACE S PHONE (360) 565 1163 OWNER RUBLE R PHONE PARCEL 06 30 00 5 1 4000 0000 APPL NUMBER 06 00000229 MECHANICAL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME6 01 3/0 9/0 6 t; q Ay MECHANICAL GAS LINE TIME 13 00 03/08/2006 03 41 PM DYASUMUR DARCY 457 0281 COMMENTS AND NOTES Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for i eview If you have an3 questions, call PERMITS (360) 417 -4815 FAX(360)417-4711 Applicant or Agent: Owner Address (0 1P Architect /Engineer Contractor S�IN MI Address c) R Ai* (h Wett PROJECT ADDRESS _b3(.0 1 LEGAL DESCRIPTION Lot: CLALLAM COUNTY PARCEL NUMBER. TYPE OF WORK. Residential New Constr Multi family Addition Commercial Remodel Repair BRIEF DESCRIPTION OF THE ND T -St& veww iEe Re -roof Move Demolition Sign PROJECT COMMERCIAL/RESIDENTIAL. Occupancy Group No of Stories. Lot Size. Total lot coverage PLANNING USE ONLY BUILDING PERMIT APPLICATION n 1 fi r-ep1a u Shy k Stove Garage Deck Existing Sq Ft. ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other Phone( 10d) SL0S I 1 3 1o0� ti-c? q OTS 1 it UJ Zip IO_ Phone U10� i1 11rr}} q� Phone. State License #�(1U��.1t1'11LY IZ IM 01 City' .■411 t III i 1 ,J A1 Block. Subdivision. STZE/VALUATION SF SF SF ZONING Phone 1 q1 S l 1103 Zip ��l /SF /SF /SF O TOTAL VALUATI N to a-firm al' a opanJ ��P (4a /ine. Occupant Load. Construction Type Proposed Sq Ft. TOTAL Sq. Ft. FOR OFFICIAL QSE NLLYY Date Rec. 3 if') 00 Permit i9 a2- q Date Approved Date Issued. 0 APPROVALS PLAN BLDG DPWU FIRE OTHER. VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Buildmg Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance. PLAN CHECK FEE IF a plan check fee is due it must be submitted at the time the building permit apphcation and construction plans are subrmtted. All other permit fees are due at the tune of pernut issuance. EXPIRATION OF PLAN REVIEW If no permit is issued within 180 days of the date of application, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section R105.3.2 of the International Building/Residential Code, 2003) No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct. 1 am authorized to apply for this permit and understand that it is my responsibility to deterr line vtat permits require ,not the City's, and that I mist obtain such permits prior to work. T�Policies\BL 1102_13.wpd Apphcant: I �i Date U t/V 1J I fl'ORT~ $4.0~~ ~ "-~ ~ ~-;-~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DMSION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 05-00001099 Date 11/15/05 013685 636 GEORGIANA ST 06-30-00-5-1-4000-0000- MECHANICAL APPL. PERMIT Owner Contractor 1f4M,t1 t9cP r2e:!J VV/( 8/(:)J/ RS7 RESDNTL SINGLE FAMILY 3200 RUBLE R 636 GEORGIANA ST PORT ANGELES (360) 457-0281 WA 983623324 PELLET HEAT CO. 230 EAST 1ST SUITE C PORT ANGELES WA 98362 (360) 457-4406 ---------------------------------------------------------------------------- Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date MECHANICAL PERMIT PROPANE FREE STANDING STOVE 64923 57.65 Plan Check Fee 11/15/05 valuation 5/14/06 .00 o Qty Unit Charge Per Extension 47.00 10.65 BASE FEE 1.00 10.6500 ECH ME-GAS PIPE 1 TO 5 ~ 'vJ (S'\ ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 57.65 57.65 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 57.65 57.65 .00 .00 -! 1\ .. ~ ~ ~.'\t""\ ~ t\e'L G~..,./~.;'\L '\ ~l:tD ~c .. ~... tJ(.:~MN ~-.\ 0 _ -))0 \~ ~ :.Ju~ -0 .~ ~J..~( {dA~ "' \AL C~N.l (~~",.... ~ '1 C'~ 2-~ cc-J2- ~ .' , Cxp~ - ~lc4-I~ ~ 'tl \J ~ ~ ;;. tJ ~ ..-.----------- Separate Permits are required for electrical W()t't(. S~PA, Shorelirl8:e~.utilities. private and public improvements. This permit becomes null and void if work or construction autl'lOriZ~'.' oo:tco~ ..180 days, if construction orwork is suspended or abandoned for a period of 180 days after the work ~co~~. or ~...... .'. ctions have not been requested within 180 days from the last inspection. I hereby certify that I havtJtelad~ EDqIlrnl~ Itlis . n and know the same to be true and correct. All provisions of laws and ordinances governing this typ!It.ofW()l1c:will.'~ ~tecl ther specified herein or not. The granting of a permit does not presume to ive authority to violate or ~celthe provislonsci~ te or local law regulating construction or the performance of constructi n. Signature of Owner (if owner is builder) Date T:\Policies\1102_15 buildingpennit inspection recotdos.wpdllMooJ} 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, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS I YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE I DOWN SPOUTS PIERS POST HOLES (POLE BLDGS,) PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW I WATER AIR SEAL WALLS CEILING FRAMING JOISTS I GIRDERS SHEAR W ALLIHOLD DOWNS WALLS I ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL I FLOOR I CEILING I MECHANICAL HEAT PUMP 1 FURNACE I DUCTS GAS LINE WOOD STOVE I PELLET I CHIMNEY FINAL DATE ACCEPTED BY: COMMERCIAL HOOD I DUCTS MANUFACTURED HOMES FOOTING I SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKlNGILIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R. W. I PW 1 CONSTRUCTION - R,W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005] ::-1.60 452 0503; # , \ _ =-',- (J r:::, : QP _......~_II......... . ...."to..... ,.,.. .. ..... "" J I.....'. ""II~;;C',l<"',,_ I'emlir _~ 0.5 - /69.9 Dol' ^pprg\,..J;_ Dal~ luuc:iJ; FlU out COMPLETELY and In L~. Your applicatiol\ And .H, plaIl MUST BE COMPLETE to b, acclIptcd fOT rniew. If )'ou hll~e any quutU>mt nil (360) 4i 7-4815 Applicant or AJent:_PIS"'LLlS"T ~ C/") Ownct;~RU~l.J; Addrl'!slI: I,,~lr., (~~O~t"..\ ,;;\uA City:~I2...-r Phone: 457-440fO M Phone: ~'51 - C2e l Af...J6~ Zip: ~"'2 _. ArchitectlEneint:er: Phone: Contr."or \1;"," "'" ~ C.D SIB" Lie.." ~iP:- ~: 4/'-' /1)7 Phone' ~7-~ Addr~s.s: '2~~C EA, 1ST' _Clty:..1:bL__"_ Zip:qg3~2 PROJECT ADDRESS: Lo'3(q (DF.'(\l2' r; I A)..,J~ ZONING: LEGAL DES(,1UPTION: Lot \ Block 4C Subdivision: _____'. CLALLAJ.\1COllNTYPARCEL m.JMB'E.R: o(O~~~14~ :redU Card !:Iokier NlIl'D$; lillu11' Al.ll.lr_: ;redlt C.,dTyp, VISA Me N :ypr, OJ' WORKl ( R~iUt:nlillJ a Nel,\l COIlII1. CI Re.roof ~ Stove ] M\llti-family Q Addition 0 Move b'oarage 1 COmrMtcle.l 0 Rl.mlod&1 t:I DeU1CllitioD 0 Deck a RllT'alf W Sign 0 Othor IRl!!:F DESCRIPTION OF THE PROJECT: I )J~~ 1 City I EEl" Datal SIZIIV ALVA nON! SF. @ S ' ISF. ... S SP'. @ S ISF. .. $ ~ SF. @ S ISF. '" S TOTAL VAlUATION $ ::t~('Jt;l f~A~ ft~/o.JDI~ 5"1'DYf. l.jo,J k __~ -: ~ 'OMMERCU.LIRESJDENTIA1.: OCc;1.lpancy OrlJup: OCCUJ:l&n1 Load: 10. of Stenes: _ Let S~c: _ ExistiDl Sq. Fl. Ie. Proflosed Sq. Ft. ::<istmg 101 coverage _ % II. Proposed lot coverago ___%... TOtld lot cClvecaic COI15tr\lction Type:__. .. TOTAL Sq .Pt. 0/, APl>ROV AJ.S: I PLAw'!: "_ BLOG: DPWU:_ lo'lRE:_____ OTHRR:_ p~c USE ONLY: E~.l,JWetlanrl(s); Cl Yes Cj No SEPAChecldtQt requU'ed? 0 Yes l:l No Other: ,1111 .OrNG PERMIT APPLICATION St:Jli\1lTT AL: The Bulldini DiYiJion r;:~ proviul: yvu ",,'ith infor.natlon on the applicutioQ o.nJ lnn submittal rcquirementllfyou hlLve qUClstiOns, 'A1.UATlON UF CONSTRUCTION: III aJl euea., vahulUnn amounl mutt be entered by the app!iclUrt. This figure will be l'Cviewed ~,d MlI'j be re"I.~ by the BullcUng Divl.ion tI) cotnp 1)' ...vith cUJTenHcc a~lwd~lcs. Contact t.h~ Perm' t Cootdin.alorat 41 7.481.5 for usistam: e. LA." CHl.CX FEE: IF Ii pllln cnel:k t'te is du.: it nU.I41 be IUblnitttd at the time the builrjina permit llpplicatiou wd conlllmr.rinn pt,ns a.re I brni ttF"-l. All other permit foos &Ie due It the timc of pennit iU\la.nce. xprRATION OF PLAN REVIEWI Jfno -PemUt III iuucd within 180 days oftl1~ J~lc nflpplic:Rtion, thl!! aJ:lpUcat.lDD will expire. The 'J lWi.<g Omcial clIn ntll1ld the time for action by the applielnl up to t80 day. upon wnttc:n roquest by the Ipplicl!lJll (Mce Section 1 07 .4~J ,':l Uniform Buildj!1~ Code, ~urrent edition). No appJillation clIn be extended more tIwl onoe. 1eraby c~rtjfy 1/16t I have (Wild lI(ld .~amlnfd this 9ppllclltlon and HrI()W the uma to Oe 1f'lJ& and ccnect. I ~m euthor1z,.,d to spply for tNs p9rmit 11M ,dersrend II1B/ ~ 10 my IWPQ(/~jbil1ty to deform'-",! wlntl permits are reqUIred ,not IMI r;lty's. afld Il8t I must obl8Jn sucI1 permit! prior fa worlc - .J"Mt..1~\A~""',RUll<lj"~ll"'T><l AppliCAnt: Dllte: // ,,.. ~~~ Installed By: CITY OF PORT ANGELES LIGHT DEPARTMENT . ELECTRICAL PERMIT PERMIT NO. cXSd'-3 3/.:2//70 , DATE Site Address: o D READY FOR INSPECTION License Number: D WILL CALL FOR INSPECTION Phone: Owner/Business: Phone: Owner/Business Address: Sq. Ft. D Residential Heat KW D Baseboard D Furnace/Boiler D Heatpump D Other D CommerciaJllndustrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) D New Construction D Remodel (I<:L Service update/alter/repair D Add/alter circuits D Auxiliary power (list below) D Special equipment (list below) D Overhead D Underground Voltage D 10 D 30 Service size D Temporary Amps Details/Description: R-~1>' ~/!. ~U ~ ~~ I IVc!/ . W.S. No. Service Capacity: D O.K. D Not O.K. D Ditch inspection O.K. D Rough-in/cover O.K. D O.K. to connect service I\f' Final O.K. Size Comments Date Hold for: D Easement D Letter D Signed up for service/meter D Meter Department notified for installation D Fire Department notified of inspection D Plan Review approved/pendi ng New Meters o Site Address: ~ '" . Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Inspector in Writing on the Wiring Report or the Buiiding Permit. PHONE 457.0411, E T..Jj8 or EXT. 224. '-l ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ,c;;:;?O f!!J ( Inspector :Amount paid WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall OLYM"'IC PRINTERS. INC. ~"J{) CITY OF PORT ANGELES' . DEPARTMENT OF LIGHT APPLICATION AND ELECTRICAL PERMIT A t~o FEE RECEIPT NUMBER PERMIT NUMBER '. TOTAL FEE '50 oZl ;f'ES - CONT.lIe. NO. TIME TO COMPLETE NO. STORIES LEGAL OCCUPANCY ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PEAMIT Sit's Address ~ tOR,6lA/J1f T ADDRESS IS REdNSIBILlTY OF APPLICANT Owner Installation By Owner's Address Installers Address Day Phone . \ . t ! f. lnstaller~ ~ho~e" ".. Application is hereby made for Permit to install Electrical Equipment as follows: (r; /L SU.UIL NW Cl./L s PERMITS WITH WRONG ADDRESSES ARE CANCELLED lEe.. fc. T'rt.4c.... 5€-,eV/C.L " ", " AptJ TO ~ 2eJo A-/J? to R fMOr:!" ( Wiring Method c.... . NUMBER AMP -120V 240V NUMBER AMP 120V 240V USE OF CIRCUIT CIRCUITS PER '" 100A FEE USE OF CIRCUIT CIRCUITS PER 10 100R FEE CIR 30 CIR 30 LIGHT SIGN LIGHT 50 VOLTS OR LESS CONVENIENCE MOTOR CONVENIENCE MOTOR APPLIANCE MOTOR DISHWASHER FIRE ~LARMS DISPOSAL BURGLAR ALARM RANGE MISC, OVEN WATER HEATER LAUNDRY . DRYER REINSTALLATION LIGHT FIXTURE # ~' SUB TOTAL FEE FURNACE . GAS, OIL FURNACE ENERGY FEE ELECTRIC BASIC FEE ELECTRIC HEAT TOTAL FEE ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER A.C. UNIT ..:Jofj AMP Gr,P PHASE FEEDER SIZE OF SERVICE ENTRANCE CO DUCTORS SERVICE A.W.G. I SUB. TOTAL 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. Electrical Code. S-ho If' h / / ByJ< , CONTRACTOR OR OWNER (OR AUTHORIZED AGEND Permission is her~by given to do the above described work, according to the conditions hereon an~ according to the approved plans and specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles:'1 ': I ~~. ECTOR 0 ,CITY LIGHT ' " Date Application made , ,g ~()/ri ED 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. for covering or service has been given by Inspector in Writing on Permit Placard. A. .'Permits Phone: 457-0411 Ext. 158. , ' ./' :', ',e Date Permit Issued WARNING PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _ WHITE. Original CANARY - Duplicate PINK - Triplicate WHITE CARD -Inspector's Report OLYMPIC PRINTEAS.INC. , . REPORT OF INSPIECTOR DATE OF VISIT MADE BY REMARKS .' .- - ^ . ~. - '. , c:tt.q , ~;. IV k-tr-' SU.IlIe.... ^f..!-" ..L ,J OJ:., I '( . . , , ,. , '. ? I~ Il (. Ilk" O.K. FOR COVERING Ij/ ,.J\ u, ,^^L . O.K.!O CONNECT SERVICE 1 -. J ~ I . z Cl a: cl: ::E !!l :r I- z W l- . I- o Z o c . r CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N? 15239 Port Angeles, WashlngtOn.OOO.h..:.h..ooo..m:mhOOOhmm....hOOOOOOOOOOOOhh' 19hm:.. 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 electrical work as listed below. , Address hh{..h.:.-'-..../m~'.h:..;.:L;:.,~m.m.....ooohooo.ooo..m.ooo.mm.. Occupancy.......L...h":"'.ooohhhm...........m. I Owner ....ooo.ooo..hhh..C-'--..L....m"......ooo.oooh.m......oooooo. TenanL..m.mhh..h.m..........hm..h.m.......oooh.......hooom. . , Wiring Contractor .m,m:..:..:....h.....m..~.'...:ooo...ooo....mh.....ooo... By.h.......m..mh.....mooooooooo:....h......hm.mm.h..h. Light Outlets________m_____._..____._._..........._.. Receptacle Outletsm_n_mnm_m____mmn Dryer, KWl nn....____nuu_. ..__._._______________ Service, volts __~______._:-:.h..:.______....~._______ Range, KW ___um No. wires ....hun___n__...._______._......h. , . Size wires_______~~::___._.___:________...h.___. . ")' , Main fuse ._h_n.-'_____~:..__=___ Enclosure __::~_______._..___._________.._...__ Type of wiring; Entrance Cable ___mumm_m........... Water Heater: KW"hhm...oo "'__"'00'00"""", . PR Heat: ltW..../.1m..oo.2....Loooo.mn Rigid Conduit m_......."..___n_________... Metallic Tubing _mn_.__..___.O_______m Current transformers: No. & Size........m__m__m___h......mn__ Motors: size, volts and phase: Ser. NO.n___.._...____..._____h._______....__...___ Ser. No..--....-___....._____________........._______. Ser. No.______._______........_.______........_....___ TJ'pe of Wiring: Armored Cable Non-Metall1c ..m__nm_..mm.......m.. Knob & Tube RIgid ConduIt '''''mm..,mmm,....... MetalUc Tubing ____ Raceway _.___..mm..._. Circuits, LighL..m..mmm__._..____..__....... Utility .______.________________..................... Heat Range .______.__________._______.__._.___......____ Water Heater ....m_...__"___............. Motor ___________h.......___.__________.___..__.. Dryer.___..____.._..._._____________...___..........___ Furnace .._____.__________........_....n..... Total Load____....__.____________...... Ser. No.._________..____....____..___________...______ Total __________..___________________________ t . ! Remarks : _._U_::h_'__'__~__:__:_:.h_____~':_~_:;::;:::\._____~_~_nn#.:__:.:u__.__~_n.u.,._______._n.n______.._u__________.__h_._______nnu_________.u._nnu Penr.1t Fee $......m_____h_ooo................. Treas. Receipt NO......_.._______._.._____m By ..._.ooo:..:~:........_ooo.....__h.h...m..."~_:..".h___.._ooo.... " NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con- ceale( 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 , I;' ~ ,- QJ? (...,/1-" ELECTRICAL PERMIT N~ 15239 l/ Date called for inspection_........._......__..._._____._._........__________._______.___......____._...h________._.....___...._..--.---..-----..._______...________.....__________.n_...___......._.__ '/ /. ~ . '\.-' I' Preliminary inspection' dates............___..:_________..._.....______ ----.---....--....--_....______ --....._.._ _.. ...________.....___.__..._______n...._____......_______..."'__0"_,___" .II( . Inspectioncompleted._.~~_~._:__~_n..:.n.:.._........_________-.----...................._____...._.._____..........____....____.__......________...____...._...._____....n.....______..n_nn..... ~otal Load '- 1M 3-72 Olympic Printers, Inc.