HomeMy WebLinkAbout0 Lakewood PERMIT
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PER)UT
Application is hereby:
TOWN OF SOUTH WINDSOR
APPROVED D BUILDING INSPECTION DEPT.
644-2511 Ext. 230
Date BuildintgI n Applications must be ApP printed or typed.
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- 1. LOCATION OF ,JOB ` lZeW0
FEE SCREDULE �No _
tLAC
i
Floor Apt. No.
i
S 0 - $19000 - $10.00
Over $1,000 - 2. OWNER
�10.00
per ion t or 3. ADDRESS
fraction thereof
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4. APPLICANI0-U'0'4-e . G�'"�
� '��lE'
T�-ica AZ> - —
5. ADDRESS
ACTUAL COST $ FEE $ 6. ESTIMATED COST $ 00-�O
ESTIMATED COST $ FEE $ 7. IS THIS A CONTRACT COST? Q YES NO
PILE COMP. BY BALANCE $ 8. FEE ENCLOSED
9. IME OF BUI LDTXC:
Pr RESIDENTIAi. 13 COMMERCIAL
10. TYPE OF JOB: �
OXIG I NAT. ALTERAT ION
INSTAI.T.ATToN C3 ADDITION
REPAIR
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I
APPLICATION FOR ELECTRICAL. Pf.Mrr(Continued tccm Keverse Side)
11. LOCAUCK 8F JON r C K
Noe STREET _ FLOOR APT. NO
12, TIP E 07 INSTALLATION _ rim✓'t1 GL'�" _
13. SIZE 07 MAIN FEEDER,_
14, No. OF LIGHT LOOPS 15. NO. OF HEAT (.00PS__ lb• NO. OF POWER LOOPS
17. NO. OF LIGHT OUTLETS 18. `0. OF HEAT CIRCUITS___ 19. NO. OF POWER Ob"N ."S—
20 NO, OF CONVENIENCE OUTLETS 21. NO. OF HEAT CIRCUITS 22. NO. OF POWER CIRCUITS
23. NO. OF LIGHT CIRCUITS 24. SIZE OF BUT CIRCUIT= 25. NO. OF ►1A.OltS
26. NO. OF PANELS 27. TOTAL WATTAGE 28, 110, OF PO IR PAIiiW_
29. N0, OF SWITCHES 30. . A/C LOAD 3E.. SIM OF PWAM FEVERS
32; NO. OF FIXTURES 33. TOTAL HORSEPOWER
34. NAMES OF SUBCONTRACTORS AND THEIR TRADES .
35, RENA= AND FURTHER DETAILS:
3
LICENSS)NO. S TORE OF APPLICANT DA
PHONE NUMBER: G7