HomeMy WebLinkAbout109 E 10th St - Building
Nov 04 02 01:181"
Bobb~ O. Coleman
360-452',"7594
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ELECTRICAL PERMIT APPLICATION
FORof'FICJ....... USE. ONLY
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The Electrical Permit Application must be tillad oul comollllelv.
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12 ",' ~ . _ ~;;QUEST INSP~CTION 0
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pjease typ. Df' reprint in ink. If you have any questions. please call (J60) 417-
4735
Fax number: (360) 411-4111
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Address:
Phone
City"
lip:
INSTALLATION WIRED BY: U OWNER ;)€LECTRlCAl COI>ITRACTC?R
Credit Card Holder Name: G) Icrn 4.. I L::~-: C" I?L 1(":
Billing Addre55~ City:_
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Zip:
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PROJECT ADDRESS.
Check all that apply: 0 New
)g.AlteralionlAddilion
TYPE OF WORK:
o Re>ldenlial [] Multi.family
o Commercial 0 Mobile Home
Sq. Ft
Number of Crlr.ulls added Or altered'
Remote Meter IJ Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump
o Low Voltage 0 Telecom. 0 Sign
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DESCRIPTION OF THE ELECTRICAL PROJECT:
Electrical Heat Load Additions
U EkIseboard
o F umace
o J-Ieat Pump
CJ Fan-Wall
-KW
_KW
- TON LRA
_KW-
PERMIT FEE: "i.{, "'t 0
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Service Information
~Verhead Service
o Temp Service
o Underground S~vice
VOllage:L~): </0
Phase: ~ 0 3
Service Size: 2mJ
Feeder Size:
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I hereby certify thaI I have read and examined this application and know thai same 10 be true and correcl, and I am
authorized to apply for this permil. I understand it is not the City's legal responsibility to determine what permits
are required; il remains Ihe applicants responsibility to determine what permits are required and to obtain such
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"16\0'1/ Credit Card Holder's Signature: -_ Date: // - Y -c::...<~,
. Owner or Elec. Cont. Signature: Date:
C:IELECTRICALPERMITAPPlICA TION
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