The URL can be used to link to this page

Home My WebLink About1105 N St - Buildingr PREPARED 6/29/10 8 43 13 INSPECTION TICKET CITY OF PORT ANGELES INSPECTOR JAMES LIERLY ADDRESS 1105 N ST SUBDIV TENANT NBR STEVEN M WOODRUFF CONTRACTOR THOMAS BUILDING CENTER INC PHONE (360) 683 3393 OWNER STEVEN M WOODRUFF PHONE (360) 452 6938 PARCEL 06 30 01 5 0 0190 0000 APPL NUMBER 10 00000206 RES ADDITION PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL1 01 3/19/10 JLL BLDG FOUNDATION FOOTING TIME 09 00 3/19/10 AP March 18 2010 4 50 32 PM 1pangrle SCOTT 460 6123 FOOTING FOR SECOND STORY DECK MORNING March 19 2010 4 50 36 PM pbarthol BL3 01 3/29/10 JLL BLDG FRAMING 3/29/10 AP March 26 2010 3 42 52 PM 1pangrle SCOTT 460 6123 FRAMING DECK PLEASE INSPECT AS EARLY AS POSSIBLE March 29 2010 4 51 41 PM jlierly BL99 Ol 6/2 /10 JLL BLDG FINAL June 29 2010 8 38 19 AM 1pangrle on 4 STEVE 452 6938 BUILDING FINAL DECK COMMENTS AND NOTES PAGE 8 DATE 6/29/10 INto 0.\ BUILDING' DIVISION CITY OF PORT ANGELES Correction Notice Job Located at /l �� Al 5J Inspection of your work revealed that .the following is not in accordance with the codes governing the work in this jurisdiction These corrections must be made and are not to be covered until reinspection is made When corrections have been made, please call for inspection Date / Inspector for Building Division / DO NOT REMOVE THIS TAG .41 V. ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 10 00000477 Date 5/13/10 Application pin number 298904 Property Address 1105 N ST ASSESSOR PARCEL NUMBER 06 30 01 5 0 0190 0000 Application type description ELECTRICAL ONLY Subdivision Name WA 98382 Property Use Property Zoning RS9� RESDNTL SINGLE FAMILY Application valuation 0 Application desc Additional desc 1 circuit exterior light LT & SW TO EXISTS Owner Contractor STEVEN M WOODRUFF JARMUTH ELECTRIC 1105 S N ST PO BOX 635 SEQUIM PORT ANGELES WA 98362 SEQUIM WA 98382 (360) 452 6938 (360) 683 4104 (.$1 S� '?Z'%7- Permit ELECTRICAL ALTER RESIDENTIAL Additional desc JARMUTH/ ADD LT & SW TO EXISTS Permit pin number 165282 Permit Fee 73 50 Plan Check Fee 00 Issue Date 5/13/10 Valuation 0 Expiration Date 11/09/10 Qty Unit Charge Per Extension 1 00 73 5000 ECH EL BRANCH CIRCUIT WO/FEEDER 73 50 Fee summary Charged Paid Credited Due Permit Fee Total 73 50 73 50 00 00 Plan Check Total 00 00 00 00 Grand Total 73 50 73 50 00 00 INSPECTION TYPE DATE RESULTS INSPECTOR. DITCH SERVICE ROUGH IN \t�' le ! evOW FINAL f) ) 8 hD COMMENTS Signature of owner or Electrical Contractor X Date 05111/2010 14 46 360-681-7272 JARMUTH ELECTRIC PAGE 01 M 4rty of Pon AnpW PefnNt Aplaficagn 321Er1Dbbbafss-P. 32t Eat PBgt itenast d► pc7Rr q, tterNcaJFeader 101�t10 Amp, P.0, em - p.C. Baer 118D part AngonVUehhrgfpn,a9f2 SanrfcetFoeder4Di4WAnn. . Ph: (360) 4174M Fa:: (M) 417.4711 $ �. Date: &inch CuaR Wl Service Fader i i & 2 Single Family Dwelling f Each Addilmol er wit CftA Mut(Wamity or Commftel' Temp. Senrkral Feeder 200 Amp. S _ Commet6al Million I Alteration / Ramodei 1 Repair - f TWO, 8arvkwl odW 401-000 Amp, Pian Review May. Be R uin P1e849 1lJ E"rical Plan Review Imbrmallon Sheet Job Acidness: rte^ TWO. SenriaelFaeder 801.1000 Amp, �` J StAWIng Square Footage: s SipruOuUna ii�t6ng Description of above 44,4r 84nd Craly UWbd Energy - Commenisl. Addl6ond f$W 35.00 S V S Signet Ci=W UWbd Energy WWFN* Darling Owner Int on �+ Name;�!!� Meiling road: City, State; 71p: i Ptxtna: .: Ucanse d I Exp, Ufdt Ch 3119.90 $ 146,50 1204.60 $ 282.20 1372.60 1 2160 $ 73.50 $ 2.60 S 92.70 $110.30 S 46,70 $181.90 f 96.90 5 66.20 s 95.90 S 83.90 5 83.90 $119.90 $102.30 S110.30 $ 35.20 $ 73$0 $110.30 S 66.00 Oemsrae dafted by RCW,1916.101: M Owner war oceupy MW aeae0rn for fao ysan Npr dUa shobfesl pa+a►It b ftnali:ser (xj diener b rsgaked fo Nn an slscdfcaf aanrrscW M above saM properiy fs foro* rant of lease. Kusa arouse oflsr shr erorr0ia of taaf Mspfcaon. Agar reading the above stnentant, i hereby arty Mut i am ft Deno of Me above named prep" or a hcaaod oloof al eeltbeotor. I am MWM9 00 aNeiricd 1nsbMe0on at ahertlon in compliance whh ft dac0tcsi laws, N.E.C. RCW. Chapter 19.26, WAC. Chow 2B64B. TM City of Port Ariplas Mrmieipat Cove, and Wily 8pscineanens. 9ignetum of owner, sbe ts) contnoar or elocotcal edminlab7lter O chock © ctiditcardt CW � Taild (ch Multlow by Unit ulama) f SsndoerFeader200Amp. $ tterNcaJFeader 101�t10 Amp, f SanrfcetFoeder4Di4WAnn. S 9arvlcelieaoar641•}000Amp. $ Servia/Feedat over 1000 Amp. S &inch CuaR Wl Service Fader i &Mch C W11 WO Service Fader f Each Addilmol er wit CftA 9 Temp. Senrkral Feeder 200 Amp. S Temp.gmvft**Ww101-400 Amp. f TWO, 8arvkwl odW 401-000 Amp, S TWO. SenriaelFaeder 801.1000 Amp, S Patd b ppl/l Mouny s SipruOuUna ii�t6ng $ 84nd Craly UWbd Energy - Commenisl. Addl6ond f$W 35.00 S Signal Ckouty Umxad EmMy 18 2 Family DwaWrp S Signet Ci=W UWbd Energy WWFN* Darling S MuUtrrkm Home Cannadbn 3 Ranewdtb E*CMW FMW 6KVA *Vw or Lot $ Fleet 1300 Some Ft 3 Each Additional 600 Spwm Fl, or Portion of S Eads OumuMding or Deuched Gamna 3 Bad►spinefwrpPoator-MT06 S Tirdmagat Oemsrae dafted by RCW,1916.101: M Owner war oceupy MW aeae0rn for fao ysan Npr dUa shobfesl pa+a►It b ftnali:ser (xj diener b rsgaked fo Nn an slscdfcaf aanrrscW M above saM properiy fs foro* rant of lease. Kusa arouse oflsr shr erorr0ia of taaf Mspfcaon. Agar reading the above stnentant, i hereby arty Mut i am ft Deno of Me above named prep" or a hcaaod oloof al eeltbeotor. I am MWM9 00 aNeiricd 1nsbMe0on at ahertlon in compliance whh ft dac0tcsi laws, N.E.C. RCW. Chapter 19.26, WAC. Chow 2B64B. TM City of Port Ariplas Mrmieipat Cove, and Wily 8pscineanens. 9ignetum of owner, sbe ts) contnoar or elocotcal edminlab7lter O chock © ctiditcardt CW � RE rVED APR 0 2 2010 10 (Dam SITZ ROOF c"i I NR"HCl C'h / (e V t 1 n Y 4 efl- R (E.A$T) CITY OF PORT ANGELESr BUILDING DMSION .108 DfESC�'c.l?r)e)A (Zkrlouu LJIMPOW. 5IL-L., catpo,c5,q 50-I 611 PL.kjI_. INStai_i_. NOMI SUiJlu(, Ptkg2. LZ NO f LTVA-T(W Of 4IL10 f:-)Li5-Tt+46 HfA9r2 KI14.6ge`0DS-) f MFL-W WPM E_I(aHT/smilraA AC? iU>L ` ori Al-M-YED C IiZCVtT 5L ItX? _ FLrASs P G I,G.fY-60. o/ T 11 51DId�(� W KOFMCID NEW Sl.la! Z RC}Z (CAST) g v15IDI'1 For2-. Qizk-pMT ro-002-06 3SEV E WOOD2.UvF O� SOUTH N zT. _ pdiZT SrS.Z 61?3 P y71? PREPARED 3/29/10 9 01 33 INSPECTION TICKET PAGE 9 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/29/10 ADDRESS 1105 N ST SUBDIV TENANT NBR STEVEN M WOODRUFF CONTRACTOR THOMAS BUILDING CENTER INC PHONE (360) 683 3393 OWNER STEVEN M WOODRUFF PHONE (360) 452 6938 PARCEL 06 30 01 5 0 0190 0000 APPL NUMBER 10 00000206 RES ADDITION PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL1 01 3/19/10 JLL BLDG FOUNDATION FOOTING TIME 09 00 3/19/10 AP March 18 2010 4 50 32 PM 1pangrle SCOTT 460 6123 FOOTING FOR SECOND -STORY DECK MORNING March 19 2010 4 50 36 PM pbarthol BL3 01 3/29/10 J L BLDG FRAMING March 26 2010 3 42 52 PM 1pangrle SCOTT 460 6123 FRAMING DECK PLEASE INSPECT AS EARLY AS POSSIBLE COMMENTS AND NOTES Ca -k- (�,ov� \ 61 o 0211 PREPARED 3/19/10 8 05 57 INSPECTION TICKET PAGE 11 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/19/10 ADDRESS 1105 N ST SUBDIV TENANT NBR STEVEN M WOODRUFF CONTRACTOR THOMAS BUILDING CENTER INC PHONE (360) 683 3393 OWNER STEVEN M WOODRUFF PHONE (360) 452 6938 PARCEL 06 30 01 5 0 0190 0000 APPL NUMBER 10 00000206 RES ADDITION PERMIT BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL1 01 3/19/10 JLL BLDG FOUNDATION FOOTING TIME 09 00 March 18 2010 4 50 32 PM 1pangrle SCOTT 460 6123 FOOTING FOR SECOND -STORY DECK MORNING COMMENTS AND NOTES G CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION 321 EAST STH STREET PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc 528 SQ FT SECOND -STORY DECK Owner 10 00000206 Date 3/15/10 373682 1105 N ST 06 30 01 5 0 0190 0000 STEVEN M WOODRUFF RES ADDITION RS9 RESDNTL SINGLE FAMILY 6336 Contractor STEVEN M WOODRUFF THOMAS BUILDING CENTER INC 1105 S N ST 4 50 301 W WASHINGTON Charged PORT ANGELES WA 98362 SEQUIM WA 98382 (360) 452 6938 165 (360) 683 3393 165 Structure Information 000 000 ADD A 528 SQ FT SECOND -STORY DECK Other struct info HARD SURFACE AREA 107 Permit BUILDING PERMIT RESIDENTIAL Other Fee Total Additional desc 528 SQ FT SECOND -STORY DECK 4 Permit pin number 161745 00 Grand Total Permit Fee 165 75 Plan Check Fee 107 74 Issue Date 3/15/10 Valuation 6336 Expiration Date 9/11/10 Qty Unit Charge Per Extension BASE FEE 95 75 5 00 14 0000 THOU BL -2001 25K (14 PER K) 70 00 Special Notes and Comments The Fire Department has reviewed the project application and has no comments March 10 2010 10 27 20 AM sroberds the proposal will result in a 576 sq ft detached garage in 13% lot coverage and 19% site coverage in the RS 9 zone No land use issues anticipated March 4 2010 8 13 31 AM Brian 417 4708 OK Public Works Utility Engineering has no requirements for this plan review Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 165 75 165 75 00 00 Plan Check Total 107 74 107 74 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 277 99 277 99 00 00 \ 0 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 has 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 coy", ucti on. 69-ls-10 SFev� lei,IM,_�,e, )/4. Date Print Name i nature of Contractor or Authorized Agent / Signature of Owner (if owner is builder) T:FonnsBuilding Division/Building Permit BUILDING PERMIT INSPECTION RECORD -- PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS — Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type I Date I Accepted By I Comments FOUNDATION- FootingsTLL- Sternwall I Foundation Drainage / Downspouts Piers Post Holes (Pole Bldgs) PLUMBING Under Floor/ Slab I Rough -In Water Line (Meter to Bldg) Gas Line I Back Flow/ Water IFINAL Date Accepted by AIR SEAL. Walls Ceiling + I FRAMING. Joists / Girders / Under Floor Shear Wall / Hold Downs I Walls / Roof / Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION Slab I Wall / Floor/ Ceiling I MECHANICAL. Heat Pump / Furnace / FAU / Ducts I Rough -In Gas Line Wood Stove / Pellet / Chimney I Commercial Hood / Ducts I FINAL Date Accepted by MANUFACTURED HOMES Footing / Slab Blocking & Hold Downs li Skirting I PLANNING DEPT Separate Permit #s SEPA. Parking / Lighting I ESA. Landscaping I SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417-4735 Construction R W PW I Engineering 417-4831 Fire 417-4653 Planning 417-4750 / 1 Building 417-4815 T Forms/Building Division/Building Permit N 1s--5 21- i YONPOR Till,A, BUILDING PERMIT APPLICATION Print In Ink y4, '*"�.•�*- CITY OF PORT ANGELES For City Use Only- Attn Building Permit Technician i[Permit# Date Received -2 - I� 321 E Fifth St. Port Angeles WA 98362 l4 3 1 (360) 417-4815 fax (360) 417-4711 Date Approve Applicant .a10 0, %i� �.�_�©U � R"La.1"'--I Phorl! Property Owner S+9_\j ,r1 fY1 Woocdt-j Phor z60 - 4/ ^7 ')- e 1� oR' Property Owner's Address 11105 S N S+_ F'14 W Pr 0(23(o2-_ Contractor'" _ 1Phone J6 ._ 6 9'3 _ 33 g Contractors Ad ress 3,g)� License #_Ao Ma B c q) `Z D b Expires �312(o 1 zo t l E-mail { / PROJECT ADDRESS Parcel Number Lot Zoning R5-9 Proiect Type & 'Brief Description. residential ❑ Multi -family- ❑ Commercial_ o Industrial Check all that apply ❑ New Construction Addition Wood — ma2-X 6 Cela, do,- k H� ❑Remodel 0Gc7�f;,.�� ❑ Repair ! I(o5gf+- ❑ Demolition?_X 12� t>9-4- +- Odin-, &Sip -PS Ssfi- ❑ Re -roof ❑ House ❑ garage ❑ other ( 504 5f +V) ❑ tear off & re -roof ❑ lay over one layer ❑ Heat System ❑ Heat pump ❑ wood -burning stove ❑ gas fireplace ❑ pellet stove ❑ other ❑ Other Floor Areas Existin_q (sq" ft•) Proposed (sq. ft.) Basement 52o @ $ per sq ft. _ $ 1 s' Floor 1 1(071 2nd Floor ) 3rd Floor Garage 5 - Carport Covered Porch 1 20/to be Deck) u n e oYerVd <j (demos -49A 52 $._ . F 12 ©O 3 Shed (S�t / Of+ �' es Other Hje 5rn`"". de , Sur�i-an� � �iY'S Rbc,} 3p to ! 1 I 2- j 572 + r2R -�� TOTAL VALUATION $ �67 Total footprint of structures 2i Z X02.. sq ft. "- Lot size _1� (ocl sq ft. = Lot coverage o2L4 b % Site Coverage = the amount of impervious surface on a parcel including structures paved driveways sidewalks patios and other impervious surfaces (see PAMC 17 94 135 for exemptions)qI6q __ Site coverage -:Z9:8 % 4 7 $ 5g f+ +1 at- c mpeA-v Ib v 5 + 2 262. - 2 I Max height of proposed structures ftoa��cupariy kd # of bedroom Will a lawn sprinkler system 'be installed? Occupant to # of full batWill a fire sprinkler system be installed? A0 Construc i n # of half the 1 have read and completed this application and know it to be true and correct. lam author"Z d to apply for this permit and understand that it is my responsibility to cletermire what permits arse" r�equireu a.7d to obtain permits prior t working on p�roj"ects/ 10 Dates ?^ I 0 Print Name 34ew 0--i\/'� . Vj ()D b kk- f- i' Signature T Forms!Building Dt ;s. n!Budding,permit application VY o V, Clallam County Assessor & Treasurer - Property Details - 62918 STEVEN M WOODRU Page 1 of 5 Clallam County Assessor & Treasurer Property Search Results > 62918 STEVEN M WOODRUFF for Year 2010 - 2011 Property First Second Account Property ID- 62918 Legal Description. SEABREEZE ESTATES Statement LOT 20 Geographic ID- 0630015001900000 Agent Code Base Type. Real Due Due Tax Area. 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11 Open Space: N DFL N Historic Property- N Remodel Property- N Multi -Family Redevelopment: N $10757 $10758 Location $000 $0 00 $: Address. 1105 S N ST Mapsco- /�cw $000 PORT ANGELES 11 / N Neighborhood: Cycle 5 Res Map ID - $000 Neighborhood CD- 10955130 2010 45476 SD #121 SCHOOL DISTRICT #121 $261 82 Owner $000 $000 $000 Name- STEVEN M WOODRUFF Owner ID- 60663 Mailing Address: 1105 S N ST % Ownership- 100 0000000000% 2010 45476 HOSP #2 HOSPITAL #2 PORT ANGELES WA 98362 $4413 $000 $000 $000 Exemptions: 2010 45476 WSMET PK DIST WILLIAM SHORE MET PARK DIST Taxes and Assessments Due $1404 $000 Property Tax Information as of 03/02/2010 Amount Due if Paid on. g-. http.//vpn.clallam.net:8084/propertyaccess/Property.aspx?cid=0&year=2010&prop_id=62918 3/2/2010 First Second Half Half Statement Base Base Base An Year ID Taxing Jurisdiction Due Due Penalty Interest Paid Du 2010 45476 ST SCH STATE SCHOOL $202.14 $202.14 $0 00 $000 $000 $A 2010 45476 CC -GEN COUNTY $10757 $10758 $0 00 $000 $0 00 $: 2010 45476 PORT PORT $15 12 $1512 $000 $000 $0 00 11 2010 45476 PORT ANG PORT ANGELES $24906 $24907 $000 $000 $000 $d 2010 45476 SD #121 SCHOOL DISTRICT #121 $261 82 $261 83 $000 $000 $000 $E 2010 45476 NTH OLY LIB NORTH OLYMPIC LIBRARY $31.26 $31.26 $000 $000 $000 2010 45476 HOSP #2 HOSPITAL #2 $4413 $4413 $000 $000 $000 2010 45476 WSMET PK DIST WILLIAM SHORE MET PARK DIST $1404 $1404 $000 $000 $000 2010 45476 CITY 77 STORMWATER CITY STORMWATER $3600 $3600 $000 $000 $000 2010 45476 WEED CONTROL WEED CONTROL $082 $081 $000 $000 $000 2010 45476 TOTAL. $961.96 $961.98 $0.00 $0.00 $0.00 _ $1S 2009 629182008 ST SCH STATE SCHOOL $231.29 $231.29 $000 $000 $462.58 20_09 629182008 CC -GEN COUNTY $11706 $11704 $000 $000 $234 10 2009 629182008 PORT PORT $1658 $1658 $000 $000 $33 16 2009 629182008 PORT ANG PORT ANGELES $25675 $256 73 $000 $000 $51348 2009 629182008 SD #121 SCHOOL DISTRICT #121 $28602 $28605 $000 $000 $572.07 2009 629182008 NTH OLY LIB NORTH OLYMPIC LIBRARY $3401 $3401 $000 $000 $68.02 2009 629182008 HOSP #2 HOSPITAL #2 $4800 $4801 $000 $000 $9601 2009 629182008 CITY—STORMWATER CITY STORMWATER $3600 $3600 $000 $000 $72.00 http.//vpn.clallam.net:8084/propertyaccess/Property.aspx?cid=0&year=2010&prop_id=62918 3/2/2010 A Single Level Deck Proposal for STEVE WOODRUFF TONY BLANKENSHIP I Contractor Sales 301 W Washington Street Presented By Sequim, Washington 98382 TONY B (360) 683-3393 CELL (360) 461-4636 FAX (360) 683-8447 (800) 281 3393 tonyb@thomasbuildingcenter.com Phone 683 3393 Page 1 of 3 Front View 3D Photo Rendering Page 2 of 3 DATE. MARCH 1 2010 Phone 477-0608 Prepared By* Fax: TONY B. TO STEVE 1105 S N ST "T PORT ANGELES PROJECT REVISION START DATE ESTIMATED DURATION Untitled Upon Acceptance March 31 2010 QTY DESCRIPTION UNIT PRICE LINE TOTAL 1 Second story deck poject including Labor and Materials. $7,254 28 42x12 w/4 landing B steps Framing treated Decking tt handrail Select tk cedar THANK YOU FOR YOUR BUSINESSI SUBTOTAL $7 254 28 SALES TAX $ 609 36 TOTAL $7 863 64 Page 3 of 3 CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N° 16446 Port Angeles, 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 City of Port Angeles, per- mission is hereby granted to do electrical work as listed below. / Address ----------- -----`= - ....... Occupancy ---tib' ------------------- -------- Owner i e_ -GL - _/_,..o. Wiring Contractor ° %P rG= -n ................ By-------------------------------------------------------•------ 1tG � -. �..`......_��.. Light Outlets .......... ... .........._... ..... Service, volts ._r:--........ Type of Wiring: le, Receptacle Outlets ........ ....................... No. wires .......... - Armored Cable ............................. Non yer• KW........ `. Size wires ....... 1...�' -Metallic ................................. �i r�'✓nd . Knob & TUbe.........._.............._..._ Range, KW.----..............._...._........ Main fuse .........._....._.......... .... Rigid Conduit ............................... Water Heater: �--. S__.—....._.._.....__ Enclosure ....................................... Metallic Tubing ........................... KW...._.. Type of wiring: Raceway ....................._......_._. _ ,C - Heat: KW...._v............ ...---------....._..... Entrance Cable .-.-......._.............. Circuits. Light��.................................. . Motors: size, volts and phase: Rigid Conduit ......................... ..... Utility ---.--'--.--------------------.------------. _...----------------------....__ Metallic Tubing ...--.................... Heat ..... ......--. ----------. --------- Current transformers: Range ..... a ................................. .__..."-`---'-`-'......-............ ............. rj No. & Size ....................................... Water Heater ....'....................... ........................................................... ................. ......................................... Ser. No........._........_. Motor ... _.............`---`_.........---'- Ser. No .............................................. Dryer -------- ..................................... ._ .................. ----........__._---- ..._........_..— - nrnac¢ ......................... ........ .......... Ser. No.............................................. Ge Total Load ............................. Ser. No.-................_.......................... .............................. Total.....J Remarks: Remarks: Permit Fee Treas. Receipt $..... -}.................... No --------------------- US 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 ELECTRICAL PERMIT 1170 16446 Address........................................................................................................................................ Date .......................................... .._------ ._ Owner................................... ....... ... _....... ...... _.._........................................................... Tenant .................................................. .._------...._.-- WiringContractor.......................................................................................................................... By .............................................................. 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. 1M Olympic Printers, Inc.