HomeMy WebLinkAbout135 Spinners Run (3) DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: 7
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
15atJ Building Inspector
Application must be printed or typed
Location of Job:
FEE SCHEDULE 13 S- c5v'#1 A c rS 2V
$0-$1,000=$15.00 Street No. treet Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
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APPLICANT 4✓i
APPLICANT ADDRESS C
cSa J f'A so
APPLICANT PHONE# l��
W N $ OWNER
O ,e4 OWNER ADDRESS 3 Sn A er V
&0) OWNER PHONE 7 C 2
c �
ESTIMATED COST$ P0
IS THIS A CONTRACT COST? Yes No
FEE ENCLOSED$ 1 S.00
Q � 1
TYPE OF JOB:
OR-Co New Installation
`—'Alteration/Addition/Rep air
Revised 4/01//2002
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
RE
_�SIDENTIAL BUILDING PERMIT APPLICATION? �❑NO
l�T
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑STORAGE
❑GARAGE ADDRESS
❑MIXED USE
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD
SIZE OF SERVICE SIZE OF MAIN CONDUCTORS
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑YES ❑NO
NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS
NUMBER OF SWITCHES NUMBER OF OUTLETS
NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS
NUMBER OF A/C CIRCUITS
SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK1 /
T` r-z o� Fj� — /2 eC.. l Teti
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
1,97(S-7 617 C- 7 CI�7Z
CONTRACTORS LICENSE NO. STATE
SIGNATURE OF APPLICANT DATE