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HomeMy WebLinkAbout913 N St - BuildingApplication Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Owner WILSON RUSSELL MERRI 913 SO N ST PORT ANGELES (360) 417 8041 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge 1 00 Fee summary Permit Fee Total Plan Check Total Grand Total CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 WA 98363 14 7000 ECH MECHANICAL PERMIT HEAT PUMP W/ FURNACE 94870 64 70 6/19/07 12/16/07 Per Charged 64 70 00 64 70 T \Policies \I 102_15 building permit inspection record05 wpd [I/4/2005] 07 00000133 462632 913 N ST 06 30 00 9 5 0200 0000 RUSS MIMI WILSON MECHANICAL APPL PERMIT RS9 RESDNTL SINGLE FAMILY 9600 Contractor AIRFLOW HEATING 221 W CEDAR SEQUIM SEQUIM (360) 683 3901 Plan Check Fee Valuation BASE FEE ME INSTALL 100- FAU Paid Credited Signature of Contractor or Authorized Agent Date 64 70 00 00 00 64 70 00 Date 6/19/07 WA 98382 00 0 Extension 50 00 14 70 Due 00 00 00 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 --10 presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction Signature of Owner (if owner is builder) Date INSPECTION TYPE FOUNDATION: FOOTINGS SHEAR WALLS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.I PLUMBING UNDERFLOOR /SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL /HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL ROUGH -IN HEAT PUMP FURNACE DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY ELECTRICAL LIGHT DEPT CONSTRUCTIONRW PW/ ENGINEERING 417-4807 I FIRE 417 -4653 I I PLANNING DEPT 417 -4750 It BUILDING 417 -4815 I T \Policies \1102 15 building permit inspection record05 wpc [I/4/2005] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FCR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS CALL 417 -4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED 4ND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. DATE ACCEPTED YES NO FINAL FINAL MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT /1's SEPA. PARKING /LIGHTING ESA. LANDSCAPING I SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE RESIDENTIAL DATE YES NO COMMERCIAL 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW ENGINEERING I FIRE DEPT I PLANNING DEPT I BUILDING COMMENTS DATE ACCEPTED BY. DATE ACCEPTED BY. DATE ACCEPTED I YES NO 02/08/07 THU 14 02 FAX 360 683 3971 AIR FLO HEATING BUILDING PERMIT APPLICATION Fill out COMPLETELY and in INK Your application and site plan MUST BE COMPLETE to be accepted for review. If you have any questions, call PERMITS (360) 417 -4815 FAX(360)417 -4 711 (7(It 1 Gevt mgdr Applicant or Agent: J'i f V t t j /J I Phone: )1 1) Owner. V d Y1 Phone: L r* u Address: li N r _V=1- city J0Q r-& A149 el fr t Zip: f t 2 Architect/Engineer Contractor Address: PROJECT ADDRESS. LEGAL DESCRIPTION: Lot: Block: CLALLAM COUNTY PARCEL NUMBER. TYPE OF WORK: Residential New Constr Re-roof Stove Multi family V Addition Mover] Garage Commercial Remodel 0 Demolition 0 Deck Repair o Sign Other BRIEF DESCRIPTION OF THE PRO CT OK, unip COMMERCIAL/RESIDENTIAI Occupancy Group: No. of Stories: Lot Size: Existing Sq. Ft. Total lot coverage PLANNING USE ONLY Phone: State License it Exp: Phone: City Zip: q, I''\f SI-rd 1 'WANING 0 /n ESA/Wctland(s): Yes o No SEPA Checklist required? Yes No Other Occupant Load: Proposed Sq. Ft Subdivision: ST h'./VALUATION. SF /SF SF /SF SF /SF TOTAL VALUATION U((000. 7() Construction Type: TOTAL Sq. Ft. FOR OFFICIAL USE Data Roe. Permit 7 l?3 Date Approved: 2 —R— 0 7 Datercwal. lei 0 7 NLY APPROVALS. PLAN BLDG DPWU• FIRE. OTHER VALUATION OF CONSTRUCTION: In all cases, a valuation amount must he entered by the applicant. This figure will be reviewed and may be revised by the building Division to comply with current fcc schedules. Contact the Permit Coordinator at 417 .4815 for assistance. PLAN CHECK FE. 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 arc due at the time of pormit issuance. EXPIRATION OF PLAN REVIEW Tf no permit is issued within 180 days of the date of application, the application will 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 Building/Residential Code, 2003). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to .apply for this permit and understand that it• responsibility to determine what permits are required ,not the City's, and that 1 must obtain such permits prior to work. 1 0 J41 Date: 0 TWORMS\BldgremtitAppl. wpd Appli [boo]. 02/08/07 THU 14:03 FAX 360 683 3971 [$/ AIR FLO HEATING I4J 001 J \ ., Job 'wired by ~ ~ 16 Electrical Contraclor 0 Owner ELECTRICAL WORK PERMIT APPLICATION Ucensr l\umt.o::r Dale EJqlires AI!l.f L-/H'lJDq t JJ, lnstBUatlon deacrtption-.l CJ CommercIal 'iJ Residential fit' Altered! Additioo ". Cll'!ew ,1 ~ l' A'lV1 {)l, 0} tAJ\JGI/II~ pmifjCS owner's(tlr~ . 1J<;.t? e bIl ~dTes5 or i2!,pection ~I '?J . " "I" btYhd ~ .A-Y1 t' lI' ^ r. ."m'or to ~cdUI' i 'peed.., /.illI ?5D r1 Owner as defined by RCW/9.18,161:(1) Owner."iJ/ oCClipy {he sm,u:tIlH::for tw" ymrs 'ffir;r 0;,) elcctrico.lf/ pemlit is fi1l11llied. (2) Ow/ler Lr requ.li'ed IrJ hlrt! /UI dl!.ctrica.J c(mlraclor if (J.b(l\lE~ soia prtJpert)' is lor .rall!. ~! (l" letLre. After reading the above statement, I hereby certify that I am 'the owner of the abvve named property or 3. licel\.OJed 1!;1l:ll;tncill c:onlr.1ctor. 1 am making the electrical instal_ lation or alteratiCll in comphane:e wilh thl:'. electric;al laws, N.n.C.. RCW. Chapter 19.28. WA Chapter 296-46B, The City of "ort ,A.Tlgele::: Ml.ll'lieip.:l1 Code. and l1(ilily S ifieations. o Cash 0 Chcck # Credit Card VISa Mastercard Discover E""piration Dale of card Card # J1N_J~:U-.L--__-____-____ 4!... :3 L{ trO . Inspection fee $ / eal Load A o NO LOAO GHAN es CI' 8aSeboal"l:! _ KW ~ Furnace IV KW 'ljII Heat Pump ~.5.. Ton q!> LAR a Fan.Wall KW Service Information CJ Oved\sad Service o Temp Service CJ Underground Service Voltage Phase 0 1 CJ 3 Serviee Size: Feecer Size: SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-473<; .. / ROOGlHN TIlERMOSTAT SEltVICE D.. ^~~IlI"~~ Uy D.. AJllMIvedB)' .- "wrovod.,y FINAL DITCH FEEDER / 2,-2. t.. -0 7 ,J.-cU D~u -A.PI'''''''''~ DJ' D"111 lI.,.pro~~<J 8y "",. ~~bY/ Inspection Area, Building or Equipment Inspected Ac.tinn. Taken Eleetri~1 Date Inspector -...- U(e:, .J~ MP!2avE:() . - .. -k?J 7/Q/f'l7 .. I , / '/ , \ 02/12/2007 16:2g 36045234gS OLYMPIC ELECTRIC PAGE 01 ..... J ; i.. ri.e<:trl... COlllr..lor a Owner last.nation desoription ~ JDb wired by C COIll",er,1Il1 Realdemllal Elcc:~ri=l ~Qn\f"Wr name UCMJ!it nUl1'Iber Dale BlI:plrel o AlleredlAddltloD ~~//- ~;;, :O--,r. OiY/1 f?r~~) PI a Ne.. PurdI r't 8ill".. IddJea rvr/7;l//'C.if- 1/,// . 'I~l/.? 7///1,,/~re/? c~ Sla.le ZIP rr 4/d~'/ t./ ;/'. :T//,?7 . Telj}~2~~ J.?")' FAXt7~2 -JYF.P prt~JtI OW-Der', alme / '/f5 vUk~/7 ,o\ddrell or la.ptetloD ~/l 5 ''///'' 57 CII~ ~ k 0d 7V;--1 PbODt number to .ebedulf IDlpeetlOGI '-//7- %oC// Owner iJJ l1~fintd by RCJY.J9.Z8.16J:{I) Ow"u will oceuPJ' tlte ,'rve',," lor' two ~ qfIu ,hi.! trlECir;CGJ pmta/f I.l flfJ~lUtd. (2) Owntr U ~u{r?J '0 hl,., a" declrlcal .-: C1HllIrZCtDl' "obow J4id pl"fJperty II for ,sole, TeIIl or ItQSl. QC\lSh Q Check # After R:adina: the above 'latefnent, 1 nenlby certifY thlt I am the OwneT or the above ~",dit Catd oamed propeny OJ a Iict1'lled electrical..conlraclOr. 1 1m making tbll eltletrlClllnSlat~ VlSl1 Mastercard Discover lation or altcnlloft in eoraplilace with tfle elecuinl lawl, N.e..C.. RCW. Chapter 19.2&, WAC. Chapter 296-46B. The Cily or PDrt Anaelel Municlpal Code, and Card # - - - -------------"--- UtiJilY SpecllicltloDS. . . Slcalture of C1W}ler, eleclrlcal c:oa~rae.tor or electrical .dlldnlslnlor E.:r.pimlion Date X ~ /".7 /. .' . ~ Date: ;2//.-2"&7 (lDSP:~~ feo of card $" ,~ , " A.... ..ft", S~rvlC8 IntorTnQtlon . ELECTRICAL WORK PERMIT APPLICATiON' i'; ! I t"" a NO LOAD CHANGES (OBoaeboanl _r:N Y/?"'''''''''C: o Fumaee J.t2r:N 0 OVorhead Sorvl<:e a liGal Pump ;Z~ ron _ LAR a Tomp Servloo o F...WaJl _I<W C Undorground SlIM" SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735 ROUCH-IN THERMOSTAT VOttagoi ;Zyt:) PhBM gr1 C 3 S.rvIoo SIze: ~ FOlder Slzo: SERVICE 0'" A'llfO"'a1 P,. Dill ^"'''''''lICl 111, D_ A,lpnl.IdBy FINAL 21z1,Io1 I DIIc 1 DITCH fEEDER D... I),1e NP"""",81 blsptctioa " Date AJea, Buildins or EljUlpmenl Inspectod Action Takeu !l..lli.a\ In.pectot \ . CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT ISSUED: 6/11/2001 PERMIT NO: 12713 OWNER/APPLICANT PROPERTY LOCATION JOEL ELLIOTT 913 N ST S 913 S.N STREET Lot: 24 Port Angeles, WA 98363 Block: [] Long Legal 360/417-3063 Subdivision: SEAMOUNT I T: S: Parcel No: 063000950200000 CONTRACTOR ARCHITECT owner N/A VARIOUS Port Angeles, WA 99360 , 98360-0000 206/000-0000 360/000-0000 PROJECT INFO Project Value: $500.00 SFD Units: 0 Commemiah 0 Project Type: WOOD STOVE SFD SQ FT: 0 Industrial: 0 Occupancy Type: Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: RS9 ~'~ PROJECT NOTES FEES ASSESSMENT Building Permit: $0.00 Misc Fee 1: wood stove $50.00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $0.00 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 Sign: $0.00 TOTAL FEE: $50.00 Plumbing: $0.00 AMOUNT PAID: $50.00 Mechanical: $0.00 BALANCE DUE: $0.00 Radon: $0.00 Separate Permits are required for electrical work, S E PA, 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 consb'uction or work is suspended or abandoned for a pedod of 180 days after the work as commenced, or if required inspections have not been requested within 180 days fi'om the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All previsions 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 Iqcal law regulatin~ construction or the perl=ormance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. PO'ST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE I DATE I ACCEPTED COMMENTS YES ] NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAENAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL CEILING FRAMING JOISTS / GIRDERS SHEAR WALL WALLS/ROOF/CEILING ~'' ;'d ~ - '~'!'~ ~.9 LZ DRYWALL T-BAR INSULATION SLAB I WALL / FLOOR / CEILING MECHANICAL HEAT PUMP WOODSTOVE / PELLET/CHIMNEY / INSERT HOOD/DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM 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. I ENGINEERING 4174807 PW / ENGINEERING BUILDING 417-4815 ~L~I~ '~r~ ~-~ BUILDING g vr CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION J2\ EAST 5TH STREET. PORT ANGELES. WA 98J62 ~ ~~P~~CdLlon Numoer Application pln number Property Address ASSESSOR PARCEL NUMBER- Application type description Subdivision Name Property Use Property Zoning Application valuation 07 00000141 Date 581064 913 N ST 06-30-00-9-5-0200-0000- ELECTRICAL ONLY 2/13/07 RS9 RESDNTL SINGLE FAMILY o Owner Contractor WILSON, RUSS 913 SO N ST PORT ANGELES WA 98363 AIRFLOW HEATING 221 W CEDAR SEQUIM SEQUIM (360) 683-3901 WA 98382 Permit Additlonal desc Permit pin number Sub Contractor Permlt Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIA~ AIR FLO/ T-STAT 94995 AIRFLOW HEATING 35 00 Plan Check Fee 2/13/07 Valuation 8/12/07 00 o Qty Unlt Charge Per 1 00 35 0000 ECH EL-LVT-FIRST THERMOSTAT Extension 35.00 ~ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35 00 35 00 00 00 Plan Check Total .00 00 .00 00 Grand Total 35 00 35 00 00 00 uJ z C/) :-1 COMMENTS/ACTION NEEDED . Y"". \ ELECfRICAL PERMIT INSPECfION RECORD ., / ... I . ,- CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, , INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPEC110N TYPE DATE ACCEPTED COMMENTS , I I " YES NO III 'C'H I WI IIlhH_lliIl CUV.hK ShRVICh I I FINAl l "].- 2.~ - c)'71~n , I I : GENERAL COMMENTS: pw.II02.1'I41961 '6!l \!J!! CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION ,21 EAST 5TH STREEt. PORT ANGELES. WA 98~62 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use property Zoning . Application valuation 07-00000141 Date 581064 913 N ST 06-30-00-9-5-0200-0000- ELECTRICAL ONLY 2/23/07 RS9 RESDNTL SINGLE FAMILY o Owner Contractor WILSON, RUSS 913 SO N ST PORT ANGELES WA 98363 AIRFLOW HEATING 221 W. CEDAR SEQUIM SEQUIM (360) 683-3901 WA 98382 Perm~t Addit~onal desc Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date . ELECTRICAL ALTER RESIDENTIAL OLY EL./ FURN. HP 95232 OLYMPIC ELECTRIC 46.00 Plan Check Fee 2/23/07 valuation 8/22/07 .00 o Qty Unit Charge Per 1.00 46 0000 ECH EL-R OR RM 1-4 ALT CIRCUITS Extension 46 00 --CJ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 46 00 46.00 00 00 Plan Check Total .00 00 .00 00 Grand Total 46 00 46 00 .00 00 \j> z ~ COMMENTS/ACTION NEEDED ELECfRlCAL PERMIT INSPECfION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE I INSPECTION TYPE DATE ACCEPTED COMMENTS I YES NO ulfCH ROT TnH.IN / COVER ~~K v ICE '",T.. T '7-,-;,t.----07 I~} GENERAL COMMENTS: PW -1102 " (4'96] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: /~, / Date ~:?- ~-~-~- ~) ( Time ~'.~OJ~ Received by ~ (phone, person) Location of Work to be inspected ~ ~[~ ~ ~ ~ Name of person requesting inspection ~ ~l'h~ Address of person requesting inspection Phone No. ~ ~ %~ ~ Permit No. i~ ~/.~ Type of Inspection (cir__: Sewer Foundation (Rramin~ Chimney Pldmbing Final Sewer Excav. Other INSPECTION NOTES~ ~ ~ ~ ~ Date ~ '~ ~ ~~~ By ~ Inspected: / Remarks: ~ . .~,~. ~ // RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved ~-~Gravel []Asphalt []PCC []Other []Repaired by City Work Order # [-1 Repaired by Permittee ~ COMPLETE ~}No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date ~-- I (~ ~d_~ l Time Received by ~- ~ Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Sewer Foundation Framing Chimney Plumbing~ Sewer Excav. Other INSPECTION NOTES: Inspected: Date '"~ !'~' ~ i Time By Remarks: RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved [~Gravel []Asphalt []PCC []Other [] Repaired by City Work Order # [] Repaired by Permittee [] COMPLETE []No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) f' tp ~ ..s c- J./ I .l~J ~>,~ /. r-J'i. .. ) ...... ~ CITY OF PORT ANCELES LIGHT DEPARTMENT ELECTRICAL PERMIT N? 15'163 P~dJ{; . '}y Port Angeles, Washlngton__________________________________________________________._._, 19........ 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 Ci7/f Port Angeles, per- mission is hereby granted to do electrical work as listed below. .;:;.. ft/ Address --,tt--~-y.-----..~'-"Y:....~~........---..-------1 tc~pancy.___~..____.__..______...._____.... ::: ~::=~~~ji:'".,:;;=---=:=.:::==:--=:: Light OutletBm_h__~..~_.m...._.___________. Service, volts m.___..___m.___nm__..........__. I Type of Wiring: CO Receptacle Outlets....._____________._____....... (- Dryer, KWlu.____._____~_u__..____m__________..__ /:2.. Range, KW _____n..___"_______.______,.. No. wires __n...____nnn..._______............ Size wires___.....___..........._______________.. Main fuse nO_____"'__.h___.h____...__.______. Water Heater: ./ KW......__$..:~...._________ He.', RW .. j{'.7 ..... 8./1. .. Enclosure __nn......nnn...__nnm___m... Type of wiring: Entrance Cable ..h...........___mmmn Motors: sIze, volts and phase: ..Id1~~______............___.______....... L/:f.~~~.....nm.......nnn-------.----... Rigid Conduit ....hnnnmn_______mm. Metallic Tubing h.___mmnn.___....... Current transformers: No. & Size.........____________________________n Ser. No....__..__..______..____...................... Ser. No.-...................____.......___.__..____... Ser. N Q. ................._.__n...._n__nn__..'h. Total :Load........._...__.......__.__.. Ser. NO...___n_________________.__.____............. Armored Cable ____________m_m_...n_.U. Non-Metallic .................___un......... Knob & Tube...____.__________...______....... Rigid Conduit n...___........_.______....___ Metallic Tubing .m..__.....__________..__ circ~::.e~::h~.~~~f~~~~~~~~~~_.~~_.~~~~~~~~~~~~~~~:. ~~::ltY_::f..~::::::::::::::::::::::::::::: d\ Range .................................____._...... Water Heater :2....___..__............... hfotor h._.....................______............. Dryer......:::b::.nn_n__nnn__.n___nnnn___.. Furnace nm.n..___....._......_m.. Total __...3..Y_____..._.___________.. Remarks: .__..nu.;.:::1.~.J?~"...,~~':.._nn:t:.!~::!:_~~~_~..nhn_n.nn..__...u.__.____n____..n_..__..UnUn_~nnn_.nn.n__n__n____.. Permit Fee u 00 $.....__.,T.L...___.._______.__...____. Treas. ReceIpt No........................_... By ...:J//t.iL.~:(,d.~(:e;t;,ti.~"c_'_,_ NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It 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 I? t'? ~. {3!3 ELECTRICAL PERMIT N? 15163 Date c.lled!i~JecGln~.::::...<b~:?:0Y.......~y........-----m...mm..m.......---....i:_~...c2f__~.>.J.::..____.. ~::;::::yc::I:t~:#~~;;:~::~:t..K;;t~:.:.:.::::.::::::::::::.:::::.:::.::::.:::::::::::::::::::::::::~=::::::::::::::::::=:::::::~:::::::~ Total ~oad nnnnnnnnn__..nn..nn....._.nn_h...._nnn..n_n_.n....n............nd .mn.................n.......n..........n_......._....n...h___n..................___n.._U__....._ \ 1M 3-72 Olympic Printers, Inc.