HomeMy WebLinkAbout204 W Park Ave - Building
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CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
ELECTRICAL PERMIT
Site Address:
PERMIT NO. 'l'/' 6??
..s- #3 /f'3
,
DATE
Installed By:
D READY FOR
INSPECTION
License Number:
D WILL CALL FOR
INSPECTION
Phone:
Owner/Business:
Owner/Business Address:
D RESIDENTIAL
D COMMERCIAL
D BASEBOARD KW ~
D FURNACE KW ~
D FAN/WALL KW ~
D HEAT PUMP KW ~
D SIGN
D TEMPORARY SERVICE
D PERMANENT SERVICE
D NEW CONSTRUCTION
D REMODEL
D ADD/ALTER CIRCUITS
D SERVICE UPGRADE/REPAIR
-gr SPECIAL EQUIPMENT
I~ (LIST BELOW)
DetailslDescription:
Phone:
Sq. Ft.
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D OVERHEAD SERVICE
D UNDERGRO~~~~VJCE
VOLTAGE: /2</,'? . t.7
[J.-SlNGLE 'PHAS
D THREE PHASE
SERVICE SIZE ~ AMPS
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W.S. No. SERVICE SIZE
CAPACITY:
D O.K. NOT O.K.
ACTION REQUIRED: D CHANGE TRANSFORMER
D INSTALL SERVICE POLE
DATE
ENGR.
D CHANGE SERVICE WIRE
D OTHER
D Ditch Inspection 0. K.
D Rough-in/cover O.K.
L;,;;J
./11" /n~ O.K. to connect service
D Final O.K.
Site Address:
Permit/Receipt No.
Installer: DSJI'3'k 3
Notify Port Angeles City Ligh by Street Address and Permit Numberwhen ready for inspection. Work must not b~ 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 Building Permit. PHONE 457-0411, EXT, 224.
~ NO OCCUPANCY OA USE ESTABLISHED UNDEA THIS PEAMIT $ _ 70 q;!?
E ectricallnspector Permit Fee
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WHITE - File by address
YELLOW - file by number
PINK - Top: Eng, Bottom, Customer,
OLYMPIC PRINTERS INC.
GREEN - Top: Meter Dept., Bottom: City Hall
t)5'b
FEE RECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
000217
PERMIT NUMBER
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/{'o ~ -- .~uJl'lf?R.... . V-:. ..........-- 'f..fpMe '.
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TOTAL FEE .
. .' ,,_.,:..~ONT. Lie. ~O" ~\TIM.E TO COMPLETE Nq. ~TORJES LEGAlQCCUPANCY
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Site Address ~() 'I Wi PAr If
. . .'. 1 O'b ". CORREC!...ADDRESS'IS RESPqNSIBIUTY OF APPLICANT.. PERMITS WITH WRONG ADDRESSES ARE CANCELLED
Owner 1Pc:\.--:~r. T 1;,. ,f3~fL " ;_, "-('''~ ,In,stall?tion By
Owner's Address I J? / [{ W (" p, II, . Installers Address
Day Phone ~ ,,/~;J /. f., () Installers Phone
Application is .h~reby made for Permit to install E!ectrical Equ(pment as follows:
-r;-Mfe (fotVST ~oCA.Je.fZ.
Wiring Method
/J, Fe.
.
NUMBER AMP 120V 240V NUMBER AMP 120V 240V
USE OF CIRCUIT PER "100R FEE USE OF CIRCUIT PER 100R FEE
CIRCUITS CIR 10 30 CIRCUITS CIR 10 30
LIGHT StGN
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': OIL
FURNACE ENERGY FEE
ELECTRIC BASIC FEE
ELEC.T~RI~ HEAT . TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
A.C. UNIT AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE It.-M Ip, AW.G.
. I SUB. TOTAL .
SIZE OF GROUND SIZE OF ENTRANCE SWITCH
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Date Application made
,19Crr
I certify that the work to be performed under this permit w I be done by the installer and in co
By
CONTRACTOR OR OWNER (OR AUTHORI 0 AGENT)
Permission is hereby given to do the aboye 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. ' \,..
, :. . DIRE TOR Of CI:rV, LIGHT
, .
3~ I~-<{J
ate Permit Issued
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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.
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
'NARNING
'~PRINTERS' INC.
WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
. ~ I ;'
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REPORT OF INSPECTOR
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DATE OF VISIT MADE BY REMARKS
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