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HomeMy WebLinkAbout1216 H St - Building Electical Permit 1216 H St 12 - 1490 d N ELECTRICAL PERMIT t CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 12-00001490 Date 11/14/12 Application pin number . . . 797970 Property Address . . . . . . 1216 H ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-3-6592-0000- on your excise tax form Application type description ELECTRICAL ONLY to the City of Port Angeles Subdivision Name . . . . . . Property Use . . . . . . . . (Location Code 0502) Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 1 circuit Ductless heat pump ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SHEARER, JOSEPH H BLACK DIAMOND ELECTRICAL CONTR 1216 S H ST 502 BLACK DIAMOND RD PORT ANGELES WA 98362 PORT ANGELES WA 98363 1 (360) 565-1035 1 �' ---------------------------------------------------------------------------- —� Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL y Additional desc Permit Fee . . . . 63.00 Plan Check Fee .00 Issue Date . . . . 11/14/12 Valuation . . . . 0 Expiration Date . . 5/13/13 Qty Unit Charge Per Extension 1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED - 63.00 ----------------------------- - Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 63.00 63.00 .00 .00 rn Plan Check Total .00 .00 .00 .00 V Grand Total 63.00 63.00 .00 .00 1�1 2 )Zd J INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN FINAL l COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGE\BUILDING CITY OF PORT ANGELES PERTNIIT APPLICATION Building Division/Electrical Inspections 321 East Fifth Street—P.O. Box 1150/ Port Angeles Washington, 93362 Ph: (360) 417-4735 Fax: (360).417-4711 ELECTRICAL d —/3" /7i1 &2 Single Family Dwelling INSPECTIONS Date: * Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: 111(, sT Building Square Footage: Description of above MP Owner Information Contractor Informa�ion Name: '5fKA-'&E%jL Name: F Mailing Address: Mailing Address °�L a?Li4GlL �•4�or�o City: 't"R State: w1+ Zip: TES G City: Pok State: .wjk- Zip: '?R363 Phone: 77a►0S`'7S( Fax: Phone: 964*9YN-3fs'•Fax: License#/Exp. License#I Exp. IN- Item Unit Charge Qtv Total(Qty Multiplied by Unit Charge) Service/Feeder 200 Amp. $120.00 $ Service/Feeder 201-400 Amp. $146.00 $ Service/Feeder 401-600 Amp $205.00 $ Service/Feeder 601-1000 Amp. $262.00 $ Service/Feeder over 1000 Amp. $373.00 $ Branch Circuit W/Service Feeder $ 5.00 $ Branch Circuit W/O Service Feeder $ 63.00 �_ $ —' Each Additional Branch Circuit $ 5.00 $ Branch Circuits 1-4 $ 75.00 $ Temp.Service/Feeder 200 Amp. $ 93.00 S Temp.Service/Feeder 201-400 Amp. $110.00 $ Temp.Service/Feeder 401-600 Amp. $149.00 $ Temp.Service/Feeder 601-1000 Amp. $168.00 $ Portal to Portal Hourly $ 96.00 $ Signal Circuit/Limited Energy-1 &2 Family Dwelling $ 64.00 $ Manufactured Home Connection $120.00 $ Renewable Electrical Energy-5KVA System or Less $102.00 $ Thermostat $ 56.00 $ Note:$5.00 for each additional T-Stat NEW CONSTRUCTION ONLY: First 1300 Square Ft. $120.00 $ Each Additional 500 Square Ft.or Portion of $ 40.00 $ Each Outbuilding or Detached Garage $ 74.00 $ Each Swimming Pool or Hot Tub $110.00 $� $ Total Owner as defined by RCW.19.28.261: (1)Owner will occupy the structure for two year after this electrical permit is finalized.(2)Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28,WAC. Chapter 296-468,The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permi t Applications. Signature of owner, elec rica ontractor or electrical administrator: ❑ cash heck El CreditCard#X Dated: 0110112012 4�.'o`w CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 121 FAST 5TH STREET, PORT ANGELES.WA 98362 v Application Number . . . . . 06-00001288 Date 12/11/06 Application pin number 784216 Property Address . . .. . . . 1216 H ST ASSESSOR PARCEL NUMBER: 06-30-0070-3-6592.-0000- Application type description ELECTRICAL. ONLY Subdivision Name . . . . . " Property Use . . . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 Owner Contractor SHEARER, JOE ELECTRIC SERVICE 1216 S H ST 82 DRAPER RD PORT ANGELES WA 983635832 PORT ANGELES WA 98362 (360) 460-2589 (360) 452-6424 Permit . . . . . . ELECTRICAL ALTER RESIDENTIAli� '� Additional desc EL. SVC./ MTR. REPAIR Permit pin number 91751 Sub Contractor ELECTRIC SERVICE Permit Fee . . . . 36.30 Plan Check Fee .00 Issue Date . . . . 12/11/06 Valuation . . . . 0 �{ Expiration Date 6/09/07 Qty Unit Charge Per Extension fly 1.00 36.3000 ECH EL-R OR RM REPAIR METER/MAST 36.30 �1 ------------------------------------------------------- ------------------ Fee summary Charged Paid Credited Due Permit Fee Total36.30 36.30 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 36.30 36.30 .00 .00 (A V,;i LI&Laon COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED cohmrx" YES NO DITCH SERVICE 3©_0 GENERAL COMMENTS: vw-um.is Ivy PREPARED 7/13/06, 8:20:56 INSPECTION TICKET PAGE 13 CITY OF PORT ANGELES INSPECTOR: JAMES L LIERLY DATE 7/13/06 ------ - -- ADDRESS . : 1216 H ST SUBDIV: CONTRACTOR : PHONE OWNER SHEARER JOSEPH H PHONE PARCEL 06-30-00-0-3-6592-0000- APPL NUMBER: 06-00000714 RE-ROOF ------------------------------------------------------------------------------------------------ PERMIT: BNOP 00 BUILDING PERMIT - NO PR FEE REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------ ----------------- --------- ----- EL99 01 7/13/06 BUILDING FINAL TIME: 13:00 JOE 683-1138 07/12/2006 11:17 AM DYASUMUR --------------------------- -------------------------------------- COMMENTS AND NOTES °°Ar yQ" CITY OF PORT ANGELES iw DEPARTMENT OF COMMUNITY DEVELOPMENT -BUILDING DIVISION v 321 EAST STH STREET, PORT ANGELES,WA 98362 Application Number . . . . . 06-00000714 Date 7/03/06 Application pin number . . . 532254 Property Address . . . . . . 1216 H ST ASSESSOR PARCEL NUMBER: 06-30-00-0-3-6592-0000- Application type description RE-ROOF Subdivision Name . . . . . . Property Use . . . . . . . Property Zoning RS7 RESDNTL SINGLE FAMILY �•'�` �,�"� Application valuation . . . . 1800 70'5/0 / Owner Contractor ------------------------ ------------------------ SHEARER JOSEPH H OWNER I 1216 H ST PORT ANGELES WA 983635832 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT - NO PR FEE Additional desc . . TEAR OFF/ INSTALL COMP Permit pin number . 81786 Permit Fee . . . . 89.65 Plan Check Fee .00 Issue Date . . . . 7/03/06 valuation . . . . 1800 Expiration Date 12/30/06 Qty Unit Charge Per Extension BASE FEE 50.00 13.00 3.0500 HND BL-501-2K (3.05 PER C) 39.65 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE SURCHARGE 4.50 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 89.65 89.65 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 94.15 94.15 .00 .00 \ V Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements.This permit becomes null and void if work or construction authorized is not commenced within 180 days,if construction or work is suspended or abandoned for a period of 180 days after the work as commenced,or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. "�, A( Signature of Contractor or Authorized Agent Date Ofnatur of Owner(if owner is builder) Date T:\Policies\1102_15 building permit inspection record05.wpd[1/4/2005] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS.CALL 417-4735 FOR ELECTRICAL INSPECTIONS. CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER,INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS SHEAR WALLS/WALLS FOUNDATION DRAINAGE/DOWNSPOUTS '� 1 PIERS w POST HOLES(POLE BLDGS.) \ PLUMBING UNDER FLOOR/SLAB ROUGH-IN WATER LINE(METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW/WATER Q AIR SEAL Q� WALLS n CEILING 1" FRAMING JOISTS/ GIRDERS SHEAR WALL/HOLD DOWNS WALLS/ROOF/CEILING DRYWALL(INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL/FLOOR/CEILING MECHANICAL HEAT PUMP/FURNACE/DUCTS GAS LINE WOOD STOVE/PELLET/CHIMNEY FINAL DATE ACCEPTED BY: 111 COMMERCIAL HOOD/ DUCTS MANUFACTURED HOMES FOOTING/SLAB BLOCKING&HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT#'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL-LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W./PW/ CONSTRUCTION-R.W. ENGINEERING 417-4807 PW/ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 / PLANNING DEPT. BUILDING 417-4815 7J /v BUILDING T:\Policies\1102_15 building permit inspection record05.wpd[1/4/2005 w` FOR OFFICIAL USE ONLY: BUILDING PERMIT - APPLICATION Date e�.:/�-3 -O& Permit I: riL out COMPLETELY and in E\TIi.Your application and site plan MUST BE Date'.Prno.'ed: COMPLETE to be accepted for review. If you have any questions,call PERMITS (360)417-4815 F_AX(360)41.7-4711 Date Issued: Applicant or Agent: To'e, G Phone: J dam^ ! Owner: 6 tL Phone: (' Address: 111� t C �1 Cit}7: ZIP:- Architect/En QiMer: Phone: Contractor State License#: Exp: Phone: Address: Citi': Zip: PROJECT ADDRESS: t 1 ZONING: LEGAL DESCRIPTION: Lot: Block: Subdivision: CLALLAM COUNTY PARCEL NUMBER: TYPE OF WORK: SIZEA7ALUATION: ❑ Residential ❑ New Constr. >(Re-roof ❑ Stove SF. @,S— /SF.=S ❑ Multi-family ❑ Addition ❑ Move❑ Garage SF. @ S /SF.=S ❑ Commercial ❑ Remodel ❑ Demolition ❑ Deck SF. C S /SF.=S ❑ Repair ❑ Sign ❑ Other TOTAL VALUATION BRIEF DESCRIPTION OF THE PROJECT: COMMERCLkL/RESIDENTLAL: Occupancy Group: Occupant Load: Construction Type: No. of Stories:_ Lot Size: Existing Sq.Ft. &Proposed Sq. Ft. =TOTAL Sq.Ft. Total lot coverage % PLANNING USE ONLY: APPROVALS: PLAN: BLDG: DPVPU: ESA/Wetland(s): ❑Yes❑No SEPA Checklist required? ❑ Yes ❑ No Other: FIRE: OTHER: VALUATION OF CONSTRUCTION: In all cases,a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance. PLAN CHECK FEE:IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuance. EVIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application,the application -"-ill expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant(see Section R105.3.2 of the International BiElding/Residential Code,2003). No application can be extended more than once. I hereby certify that 1 have read and examined this application and know the same to be true and correct. 1 am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required,not the City's, and that I must obtain such permits prior to work. T:\FORMS\BIdgPerraiteorm.wpd Applicant: Date: �� O OE PORT 4A,C =sN CITY OF PORT ANGELES� 7 LIGHT DEPARTMENT PERMITNO. ��` 3 c� ELECTRICAL PERMIT DATE TY LION Site Address: ❑ READY FOR "ILLCALL FOR INSPECTION INSPECTION Installed By: License Number: Phone: OwnerlBusiness: Phone: Owner/Business Address: Sq. Ft. p Residential ❑ New Construction ❑ Overhead (( Heat KW ❑ Remodel ❑ Underground ❑ Baseboard ❑ Furnace/Boiler ❑ Service update/alter/repair Voltage El Heatpump ❑ Other ❑ 10 1130 ❑ Commercial/Industrial load ❑ Add/alter circuits Service size Amps Total Connected load ❑ Auxiliary power ❑ Temporary (attach breakdown) (list below) Total Motor load CXSpecial equipment (attach breakdown) (list below) Details/Description: W 141 W.S. No. Service Size-Date-Hold for: ❑ Easement ❑ Letter Capacity: ❑ O.K. ❑ Not O.K. Comments ❑ Ditch inspection O.K. ❑ Signed up for servicelmeter ❑ Rough-in/cover O.K. ❑ Meter Department notified for installation O.K. to connect service ❑ Fire Department notified of inspection /VFinal O.K. ❑ Plan Review approved/pending Site Address: Permit/Receipt No. /Z16 0 /x-3 Installer: New Meters Date: ID 6 - 6 - 9 ® Notify the Departmen of Ci y Light by Street Address and Permit Number when ready for inspection. Work must not be covered r electrically energized before inspection and O.K. for covering or service has been given by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.04WEXT.158 or EXT. 224. �1 NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT Inspector Amouunn/t paid WHITE—file by address YELLOW—file by number PINK—Top:Eng,Bottom:Customer GREEN—Top:Inspector,Bottom:City Hall OLYMPIC PRINTERS. INC. CITY OF PORT ANGELES o ELECTRICAL PERMIT LIGHT DEPARTMENT N? 15191 � t Port Angeles, Washington--- t f------ ---'Z'--`--- ------------------------------- 19... -tf In accordance with the City Ordinance to regulate the installation, extension, or repair of elec- trical equipment in, on, or about any building or other structure in the City of Port Angeles, per- mission is hereby granted topp do electrical work as listed below. Address JA...L6--------_.7�_t--------- ----------------------------------- Occupancy---- ----- ` ``- -"-�---------------- Owner ------------- -) . v- ---------- Tenant----------------------------- ------------ ----------------------- Wiring Contractor------ -'�G�lLI ------ By------------------- ..t ---------- ---------------------------- Light Outlets...._----------;L....V---------------- Service, volts .._t_a'_,_`._�:4._C Type of Wiring: Receptacle Outlets--------It-(- No. wires ............2?----------------------- Armored Cable ..._------._------_-...._. c /I', JJ �._. Non-Metallic --------------------------------- Dryer, KW�....-....---'-"---"--�------'----- Size wires..--'--�L..........:._.......-.. K�^� ....... Knob & Tube.-........-------------------_.. Range,KW---------------------_ I -----...._-- Main fuse ........:.1-:�-'J .......-. Rigid Conduit ............................... Water Heater: Enclosure --------------------------------------- Metallic Tubing 1 .a---- ------------ Type of wiring: Raceway ------------------------------------------ Heat: ---------. Entrance Cable - -- ---- nn ----------- Hent: RN.........................�._4).......a_l!:� e 'J Circuits. Light......_.._......a....----------- Rigid Conduit ------------------------------- Motors: size, volts and phase: Utility ........................�.--------------- ..... ------------------------.11 J-R ---- -'- --' Current transformers: Range ........................................................... No. & Size....................................... Water Beater ----------ir...:............. ......................................................... Ser.No.._.........-------._---------------------- Motor ---------------------- ._........._--------------------------------------1-1.... Ser. No.............................................. Dryer............................?-......... ---------------------------------------------------------- Ser. No. -------------------------- Furnace ............................................ Total Load............................ Ser. No.--------------------------------------------- Total ........... Remarks: ----------- 1"0' � t ......... �` ` ``` ' - - t _ ---------------------------------------- -------------------------------------------------------------------------------------------------'--'---------------------------- --------------------------------------------------------------------- -------------------------------------------------------------- ---------------------------- Permit Fee Treas. Receipt $-----------2,-'--f-D----------. No-------------_-------------- By ---------- --------------------- --------- NOTICE­-Curreat must not be turned on until Certificate of inspection has been issued. If work 1s to be con- cealed due notice must be given the Inspector so that work may be inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION C) ' �J • ELECTRICAL PERMIT N° 15191 / C �[/ -7 Date called for insPecfidn-- =--------------- -P--------- .-----------......_................-.:.........................................-...-......`}.....r....... ...{7.._ --/ r`1 --- Preliminary inspectiondat .........._....r..?:::-::...:...............~:.... J...�...�.................................................................................-.................. Inspection completed..._.._.._.........-_--.-.._� v r ................... ................................................................................_-..........-......_........-......_ TotalLoad .------............-.....................-_.....-....---......-----------.........------...........---------...............-_..._..........-. 1M 3-72 Olympic Printers, Inc. CITY Or PORT ANGELES O ELECTRICAL PERMIT LIGHT DEPARTMENTNe 1518 3 Port Angeles, Washington-.t -------------------------------------------------------- 19_74 In accordance with the City Ordinance to regulate the installation, extension, or repair of elec- trical equipment in, on, or about any building or other structure in the City of Port Angeles, per- mission is hereby ))granted to do electrical work as listed below. Address-L[ J- L�-----�°---------H---•---------- -----------_---- Occupancy---------- - ......-- ----_-------- Owner � / i �°--'�---�...0_�� -f rf-i-/Y7q rS Tenant---------------------- - Wiring Contra�°cytor ^ t 1'� -a-/F----------------------- By----------------------------------------------...-...........------ Light Outlets......;Z—.._�.................. Service, volts ....../.. S! Type of Wiring: Receptacle Outlets_f"� ..... No. wires --------------3_------------------- Armored Cable ............................. C ir�� A 1, Non-Metallic ------. Dryer, KW4............. r.-...........___.....-_ Size wires.......�1.....----------- ------ ��11 Knob & Tube......................__........ Range,KW..-_....... ........._..........._. Main fuse ..._. _l-r..t�.------.Y - Rigid Conduit ---- Water Heater: Enclosure --------------------------------------- r� Metallic Tubing .._._.................... , KW............... .. . .. ..�.-----5-------------- Type of wiring: Entrance Cable Raceway ------------------------------------------ Ileal: RW......... .. ....f....L.i.. ... ..... Circuits, Light-........Is------------.......... Rigid Conduit ............................... +� Motors: size, volts and phase: Utility -------- ---------------- Tubing --- - ..�.�...�1•i.:.-.=.-�'a Heat ......-.-...'j�i~.......... ................... Current transformers: Range -------------------- -. -------------- .. ........................................ No. & Size ................ . Water Heater --------- --------------------------------------.................... Ser. No............................................... Motor ...... Ser. No.-----_ ------------------ Dryer.......................',2- .-.__...----_-..-------------------------------------- Ser. No.--------------------------------------------- Furnace ..........................-............ ..... Total Load .. Ser. No------------------_.-------------.-------_- Total -------- .....�2",�-_...... Remarks- ---------------- -----------------------------------------------------------------------------------------...... --------------------- -------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------I---- ----------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Permit Fee Treas. Receipt $--....1Jq---- No----------------------------- By ----------•---- `^.K-----------f•!���^r_ -.ct„ NOTICE--Current must not be turned on until Certificate of Inspection has been issued. If work is to be con- cealed due notice must be given the Inspector so that work may be inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION 0 kt J. -2 12 ELECTRICAL PERMIT N° 1518 3 Date called/zor'fn9Dofetion-------,----------------../ .:�'..............1L—: / ? � �1 ...................... — .wr_....... .._ Preliminary i`s>�Peouol3fdatescz �1 -.^.-_`...:......................--------------..............-------------------------------*---------------- Inspection complet d4. — i... TotalLoad ----------------------------...........-..-.........---..._...._----------'-----......-------------..........._...-----...............................-. IM 3-72 Olympic Printers, Inc. J rang ELECTRICAL WORK ERMITAPPLICATIONr .1a Installation description Job wired by L�F,lectrical Contractor ❑Owner ❑ Commercial 14 Residential Electrical contractor name { License number Date Expires Altered/Addition G— lee.` - G C SO'ryi ce- 1.f'� LKC T$T 1'3 22 1`11 New V-: Purchaser's mailing adZ ess 1 I a Sy-ucxv- 144'1 rt pot (L< `0 Cityy� State 'LIP Port A K6,e- Ii A 9-3 4.-- Y)­v.4.'s Telephone tu n ber V FAX number '(52- to Premises Pwnename `r+M,� V br's J 1 U_c,(-'�P' Address of inspection Lti S n N City P Phone num er0 schedule inspection: Owner as defined by RCW.19.18.261:(1) Owner will occupy the stntclure for Dvo years after this electrical permit isfinalized. (1)Owner is required to hired,,electrical contractor if above said property is for sale, rent or lease. ❑ Cash ❑ Check# After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. 1 am making the electrical instal- ❑Credit Card Visa S(ercard Discover lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter pp�� 19.28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and Card# Utility Specifications. Signature of owner, electrical contractor or electrical administrator Expiration Date 'a, I of card $spection fee X Date: 36 Electrical Load Additions and or subtractions Service Information ❑ NO LOAD CHANGES // Ll Baseboard _KW Voltage I�- A", 9 ❑ Furnace —KW XZOverheacl Service Phase k1 ❑ 3 ❑ Heat Pump _Ton_LAR ❑ Temp Service Service Size: 200 A- ❑ Fan-Wall _KW ❑ Underground Service Feeder Size: SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735 ROUGH-IN THERMOSTAT SERVICE Dne Approved By D:ne Approved By Dam Approved By FINALDITCH FEEDER /^/ Dem App Dale Approved By EDale Approved By Inspection Area,Buildingor Equipment Ins ected Action Taken Electrical Date Inspector � 0-6