HomeMy WebLinkAbout2621 S Laurel St - Building
"
()~ J 'l
FEE RECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A tJ 0 t) IJ 'l':J-.
PERMIT NUMBER
.
. TOTAL FEE
/~__C}D-"
- '
- "\,' \
CONT.lIe. NO.
TIME TO COMPLETE
NO. STORIES
LEGAL OCCUPANCY
ELECTRICAL PEAMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
f.., 2/ J. r=..L Dr<:. ' tJG-aiE
. CORRfe! fDDREA IS RESPONSIBILITY OF APP~ICANT PERMITS WITH WRONG AD~!S~ ARE CANfELLE '/J Il W
OwnerIYJIl-SDN uR..owN€.. Installation By IfinSoN O~() NE:.
o'wner's Address '-:J.~ '2} 5,.L..::L\..{ r:a.rD Installers Address 'UU ~ LA-u.~J
Day Phone W. J.fsz-: 738"- W. 374-" :;1,,'1' Installers Phone ,,.:,is"2- -7 <, ~ fa
Application is hereby made for Permit to install Electrical Equipment as follows: /A./ i IZ./E. /fill II" it Iif. '
r..DYI1R/A)lPf)o"J RooNl P::::OR. I...UE;~J j..;&1-lT-.S; 147Jf)
{)u:r L..J:""Is"
Site Address
Wiring Method
J\..,I ,
.;
NUMBER AMP 120V 240V NUMBER AMP 120V 240V
USE OF CIRCUIT CIRCUITS PER 10 100A FEE USE OF CIRCUIT CIRCUITS PER 10 100R FEE
CIR 30 CIR 30
LIGHT / <20 X SIGN
LIGHT - 50 VOLTS
OR LESS
CONVENIENCE MOTOR
CONVENIENCE MOTOR'
APPLIANCE MOTOR
DISHWASHER FIRE ALARMS
DISPOSAL BURGLAR ALARM
RANGE MISC.
OVEN
WATER HEATER
LAUNDRY
DRYER REINSTALLATION LIGHT FIXTURE #
FURNACE SUB TOTAL FEE
GAS ~ all
FURNACE ENERGY FEE
ELECTRIC .
;'~D /6 BASIC FEE
ELECTRIC HEAT / ;).0
TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
A.C. UNIT AMP PHASE
- -
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE A.W.G.
I SUB-TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH
I certify that the work to be performed. under t~it will be done by the Installer and In con
Date Application made 00-+-0 I-f, 19 'i?Lf By
CONTRACTOR OR OWNER (OR AUTHORIZED AGENT)
Permission is hereby given to do the above described work, according to the conditions hereon and according tothe approved plans and
specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles. - .' ' - /. <.'
, DIRECTOR OF CITY LIGHT
WARNING
~CA~VED
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. tor covering or service has been given by Inspector in
Writing on Permit Placard. A. . Permits Phone: 457-0411 Ext. 158.
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
Date Permit Issued
.'
WHITE. Original CANARY - Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
Ol YM~C PRINTERS. INC.
C-'./ - ,,'V\
.4......;1 t' .J' ~...J .}
REPORT OF INSPECTOR
'~\'l:~" .~
DATE OF VISIT MADE BY REMARKS
-- .
(- IU ' gs- /!I/ yJ s rd L 41"t(I(,"'G- ~ At nOONT.. .
'" .......\ " ,
-.
"
.
,
., -
, .. .
. "
"
.. ,
. ; ,
..
. ..
,
.
.
" "
..
,
..
" . . .
"
.. , '. .
.
p ~. -
"
.
.
.
..
,- \ l\ /1 \\ /
.
~ N\\.. ~ 'h.\ \f'1/ .
O.K. FOR COVERING
"- O.K. TO CONNECT SERVICE ,
J)~/,b' 'DeS' /fl /S , '.I-
FINAL O.K.
"
'. "
.
z
CJ
II:
Cl:
:i!
!!.1
J:
I-
Z
W
l-
.
l-
e
z
e
Q
..