HomeMy WebLinkAbout722 Georgiana St - Building
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CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
.. DUi) 2 ;.5:3 II
A
F~R-~P(NJER
PERMIT NUMBER
.
Site Add ess
Owner
TC TAL FEE
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NO. STORIES
LEGAL OCCUPANCY
ELECTRICAl PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
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CORRECT ADDRESS IS F'l PONSIBILlTY OF APPLICANT
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PERMITS WITH WRON/:JDDRESSES ARE ;~NCELLED.
Installation By nj 02-{ tZ,) TZ:/eeT{' I c:..r
Installers Address ',S-~ '-f E:sT 1ST
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Owner's Address
USE
L1GHl
L1GHl
CONY
CONY
APPll
DISH\i
OISPC
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OVEN
WArE;
LAUN'
DAYEI
FURN.
GAS.
FURN.
ELEC-'
ELEC~'
ELEC'
A.C. U
FEED!:
SERVl
Wiring Method
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NUMBER AMP 24QV NUMBER AMP 120V 24QV
OF CIRCUIT PEA 12QV 100R FEE USE OF CIRCUIT PEA 100R FEE
CIRCUITS CIA 10 30 CIRCUITS CIA 10 30
I J-i> /~ SIGN
50 VOLTS
OR LESS
NIENCE MOTOR
NIENCE MOTOR
NCE MOTOR
A.SHER FI RE ALARMS
lAL BURGLAR ALARM
MISC,
HEATER
AY
REINSTALLATION LIGHT FIXTURE It
CE SUB TOTAL FEE
lIL
CE ENERGY FEE
elc BASIC FEE
:UC HEAT J Jo '))o,M -56 ,"7,0 C.,.,~
TOTAL FEE -
~IC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
liT ,"1,,-1"\ ~ AMP / ~
PHASE
e SIZE l)F SERVICE ENTRANCE CONDUCTORS
:E qh k.L- A.W.G.
I SUB-TOTAL SIZE OF GAOUND '# 'r SIZE OF ENTRANCE SWITCH -.h~
,19
~
I certif, that the work to be performed under this permit will be done by the installer and in conform
Date Ai plication made ~/ if;/ fS
e with the N.E.C. Electrical Code.
,
By
CONTRACTOR OR 0 ER (OR AUTHORIZED AGENn
Pe mission is hereby given to do the above described work, according to the conditions hereon and according to the approved plans and
speclfl' atlons pertaining thereto~su~ct : c;;e with the O~dy1nanCf/fes of t1 c~ ~~T~~GHT
DateP,rmltlssued /1 r-- __~~ _~
'-( PLANS A P veD
Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must n?t
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.
~
I WA RNING I
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER-
WHITE - Original CANARY. Duplicate PINK. Triplicate WHITE CARD - Inspector's Report
~
REPORT OF INSPECTOR
-
,
DATE OF VISIT MADE BY REMARKS
5-/0 f'S-'- -7?:f:Y Kc €/? J {J", s~,,(/C- oN GMT Go I /jI (/- l! ;\/ f)..: Ii
lIocl5<'
~
t- I LIGHT [J LIGHT 0
~ TuRN ON WATER 0 Date SHUT OFF WATER 0
l- I ,
I
NAME ADDRESS ACCT. NUMBER
l-
t- DEPOSIT
" Mailing Address AMOUNT
=:
I- .. The undersigned hereby makes application to the City of Port Angeles for Utility Service subject to the terms and conditions
"
'ii of applicable City Ordinances which are hereby agreed to and are made a part of this application.
" :
r::: NEW APPLICANTS:
EMPLOYER ADDRESS
- -
PHONE NO.
2:
~ 0 0 PROPERTY OWNERS NAME
OWN RENT
"C
2: PREVIOUS RESIDENCE ADDRE~S
~ CITY STATE
-= APPLICANT ACKNOWLEDGES RECEIPT OF A COPY OF "CITY OF PORT ANGELES _ GENERAL
.; E INFORMATION RESIDENTIAL UTILITY SERVICE".
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~ ~ SIGNATURE Date
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"C
i 0 OLYMPIC PRINTERS, '""
. - - ,. -- ..
5-10- 15' ') -'ll.r 2J O.K. FOR COVERING
S:/6--/'" llF~ O.K. TO CONNECT SERVICE
r/- '0- /S /71f"-A FINAL O.K.
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