HomeMy WebLinkAbout0 Sele Drive PERMIT
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT 3 !
Application is hereby : TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
644-2511 Ext. 230
a e ing In ector Application must be printed or typed-
e
r 1 . LOCATION OF JOB
FEE SCHEDULE No . Street
�O
$ 0 - $19000 - $10.00 Floor No.
Over $1,000 - $10.00 J)
{ 2 . OWNER
per $1 ,000 or
fraction thereof > /�
3. ADDRESS
SIN
4 . APPLICANT .L w/��1 a)" ,(G
5 . ADDRESS yid �1gie ��
6. ESTIMATED COST $_
I
7 . IS THIS A CONTRACT COST
i
i Yes No
8 . FEE ENCLOSED
9. TYPE F BUILDING:
RESIDENTIAL COMMERCIAL
10. TYPE F JOB:
Original Installation
Alteration/Addition/Repair
I
Rn 3A 11/88
r
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB ,5e)e— 32ep
NO. STREET . NO ,
�o
12 . TYPE OF INSTALLATION
13 . SIZE OF MAIN FEEDER
14 . NO. OF LIGHT LOOPS 15 . NO. OF HEAT LOOPS
16 . NO . OF POWER LOOPS 17 . NO. OF LIGHT OUTLETS
18 . NO . OF HEAT CIRCUITS 19 . NO. OF POWER OUTLETS
20 . NO. OF CONVENIENCE OUTLETS 21. NO. OF HEAT CIRCUITS
22 . NOo OF POWER CIRCUITS 23. NO. OF LIGHT CIRCUITS
24. SIZE OF HEAT CIRCUITS 25 . NO. OF MOTORS
26 . NO . OF PANELS 27 . TOTAL WATTAGE
28 . NO . OF POWER FEEDERS 29 . NO. OF SWITCHES
30 . A/C LOAD 31. SIZE OF POWER FEEDERS
32 . NO . OF FIXTURES 33 . TOTAL HORSEPOWER
34. NAME OF SUBCONTRACTORS AND THEIR TRADES /,�rr / �CTi�'/G
35 . REMARKS AND FURTHER DETAILS :
LICENSE NO. GNA 0 APPLICANT DATE
PHONE NUMBER: e6;`1 " 5Frld
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-INSP^CTOR DATE TIME J�t'YI
LOCATION
per.
INSPECTION: CODE: RESULT(D/A) :
BUILDING:
ELECTRICAL:
PLUMBING:
4•
HVAC:
OTHER:
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