HomeMy WebLinkAbout0118600 P
03/21/2005 10: 05
2335747
J RASMUSSEN
PAGE 02/02
"
~
DW.iB
Ci'y,Co,"'"h
~i,¡,¡,n orin"""", SO"I""
," <:"...1, ""..,
pOk.."",
{J,"",II WI ~"'(".I!"
011\" "¡¡.,.~ .,,
r.. "'-'%-soa-
Electric Instal1ation VerificanoI;\
ÜG"tT~¡C
(Electrical Contractor Name)
YClo & RD FF PiC-l(e-V WS, st.¡q¿,L
(Address) (City) (State) (Zip Code)
have been contracted to perfoIID el.r,tric installation work for~ lZ-A-:s~u~S&J Pt~.vy
(Name ofpllrty contracted t~)
I (We)
D (è ç X Ù;,c.
at the following address:
~ \ (.. s-riLUUEtc. ~
(Address wh,ere work will be performed)
The naturè of the work consist. of: (Check One or Describe the Nature of Work)
- Reconncctißn or new circuit for replac.1mlent Healing PI:mt ood/or AlC Conderiser.
~ Roconn..,.tioll or new circuit for rep.lscem<mt Electrio Water Hoatcr or power vènted
wat/:r heater.
-- Rcconncction of the Service Entrance Cable, Meter Box, alterations to rccepta~l""
and lighting fixtures dueto sidin,g / soffit ìnstal1ation. Note: New Service
Entrance Cables will require a separate permit.
- R.""'DllQotion or new ..i,..uil for the ""pl""ement of other pcnn..n""ll y wiNd
appliances f fixtures.
- New cirellit for thli' ~Iddi!ion of AlC to an lndivJdual dwelling unil (hollsc or the
il1diviJua; s.v.t~ms in a ciuplex or condominium), inciuáing required service
electrical outlets. - - :
- Other
TbevaJueofthisworkis$ '2oc>. C-
I hereby verify this work wiJI be performed by an =ployc:e ofthis company and further verify
the reconneotion f installation will be done In compliance with manufactUrer and Electric code
.requirements.
~ Ll/f' D, DU)(LQe
(print Name of Officer)
3 ~ ¡"i-ok
(Dote)
~IO2
.. -.--.. -", ..-
1O'""
Wd Q1:~0 gøøz-~t-~~W