HomeMy WebLinkAbout613 W 13th St - Building
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ELECTRICAL PERMIT APPLICATION
FOR OFFlC'^!JfE Or~ _ ~
OatclRec" - ("..,I "-
Permil~" ~ J Ii
DateAp~ved: 7
Dalelssu.ed:
The Electrical Permit Application must be filled out comDletelv.
Please type or reprint in ink. If you have any questions, please call (360) 417-4135
Fax number: (360) 417-4711
138i
Owner or Elee. Contractor Agent
B (',t-t6 V\.
Phone:
REQUEST INSPECTION 0
Fax: '1f>7 -7~t?:3
Phone: 4.l:{f! - 4 4 c:=) ~-1
PropertyOwnec ED HFRERT / lLt>A
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Address: /" j ~ HI am
Electrical Contractor: I-!lhVr,RS'f:1./ r,. r::U::CrRIC
Address: /47(- W J!~
INSTALLATION WIRED BY:
DOWNER
City: PeRl: /i!Jr;GI Fe:,
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License ttf{IJIV;IE:!i,.,q -Exp:
City: PcW, fJ ^!f~ t: L [;S
f\ElECTRICAl CONTRACTOR
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il/-ll i!r:'P. "FiVe: l""1 ;;r;TR) c:
Zip: ag36. ?
~/n.Jr,/.) Phone:4K7- 'J(:lo3
Zip:
Credit Card Ho/der Name:
Billing Address:
i4?t, 1M ilTh
City: Poi7T Ijl..k,FiE<;
PROJECT ADDRESS:
(/;/'7, iAI n /1)
Check all that apply: Y( New
o Alteration/Addition
TYPE OF WORK:
o Residental 0 Multi-family
o Commercial 0 Mobile Home
Sq. Ft
Remote Meter ~Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump
Number of Circuits added or altered: I
o Low Voltage 0 Telecom. 0 Si!
DESCRIPTION OF THE ELECTRICAL PROJECT: lJEIfJUIFJ7 ?'I)/?AC;io;
Electrical Heat Load Additions
PERMIT FEE: 1!JJI@
Service Information
o Overhead Service
o Temp Service
o Underground Service
Voltage:
Phase: 'ill 1
Service Size:
Feeder Size:
03
o Baseboard
o Furnace
o Heat Pump
o Fan-Wali
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PAMC 14.05.060(B): For industriai, commercial, & residential projects iarger than a duplex, a one -line drawing of the Electrical Service &
Feeders, building size (sq. ft.), load calculations, and the type & of conductors andlor raceway is required and shali accompany the Electric;
Permit application.
/ hereby certify that / have read and examined this application and know that same to be true and correct, and I a/
authorized to apply for this permit. I understand it is not the City's legal responsibility to determine w
Credit Card Holder's Signature:
ffp"'J 1rJ #effH\J~1
"~->"HC1 117 AI-: {J-#i':1Jl:l1,
!/ .5e:1<'I1~6" i".~TEO
Date: 7/;//02-
Date: 7,/; J If) i?_
L-'-'~ q384-
Owner or Elec. Cant. Signature:
C:/ELECTRICALPERMIT APPLICATION
/J(.,rtj-J C an m../ '7 -;1- t') Z-
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