HomeMy WebLinkAbout710 E 2nd St - Building
ELECTRICAL PERMIT APPLICATION
fOR OffiCIAL USE ONLY:
D.",Rec:.:
Permit II: 7 ~ ~ '!
D.", Approved;
DaIoWued: <:"" /:? 2 /o{
, ,
The Electrical Permit Application must he flUed out completely.
Please type or print In Ink. Uyou have any questions, please call (360) 417-4735
Fas number: (360) 417-4711
Applicant and/or Agent: Colcmlht ~ic Phone:
Property Owner:
Fax# q502-7r?~
Phone:
Address:
Contractor
Address:
City:
License #:
City:
Exp:
Zip:
Phone:
Zip:
80bb~ (). c,k:nll1-U
Billing Address: SZz.... W. lIP 4.{., CilY.lb~f-,4.,'rl<
.
CreditCardNumberLf~/ Exp.Date:
Credit CardHolder Name:
Zip:'7<f.76 Z.
VISAX MC_
."."A
PROJECT ADDRESS:
7/0
c~ ;( ~'\.c;.t.
ZONING
LEGAL DESCRIPTION:. Lot:
Block:
Subdivision:
CLALLAM COUNTY PARCEL NUMBER:
TYPE OF WORK:
o Residential 0 Multi-fanuly 0 Commercial 0 Mobile Home
Electrical Permit fees are based on WAC 296-46-910
BRIEF DESCRlP'l:ION OF mE PROJECT:
e~~j e..-
S~I'.J: c..e..
A&ct e;l<!.
Electrical Heat Load Additions
Service Information
o Baseboard
o Fwnace
o Heat Pump
o Fan-Wall
KW
_KW
KW
KW
o l'tiser
o Overhead Service
o Temp Service
o Underground Service
Voltage:
Phase: 0 1 0 3
Service Size:
Feeder Size:
.Comments:
I hereby certify that I have read and examined this application and know the same to be tlUe and correct, and I am authorized to apply
for this pennit. I understand it is not the City's legal responsibility to determine .....nat permits are required: II remains the applicant's
responsibility 10 determine what permits are required and to obtain suJ.!~ ~ c:.tf~ .
PW-1l02_23 [...31.00) Credit Card Holder's Signature: ('.<;a A ~ C!.Q. ~ Date: 5/"100