HomeMy WebLinkAbout18 Alison Drive (13) DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PER�11T N
Application is hereby TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bldg Permit#
APPROVED 1540 SULLIVAN AVENUE
6. 4-2511 ext. 230
Da wilding Inspector Application must be printed or typed
Location of job
Street No. Street Lot No.
FEE SCHEDULE
Floor Apt. No.
$0 - $1,000 - $12.00
Over $1,000 1
/
$12.00 per$1,000 OWNER. n old eL,CJ L.• 25L L15 1/14/
or any fraction thereof
ADDRESS ��4- /S��n, ��/<r V,�-,
,��, , VLIlA-)0SOk C7 n��) i�
OWNERS PHONE#
APPLICANT J&0AJXL0
OW N SF ADDRESS .Jd� ,�L/LfCah.) d
O ESTIMATED COST$44
Ur�
C = IS THIS A CONTRACT COST? X
YES NO
' ICJ FEE ENCLOSED $ I
OR-Co TYPE OF JOB:
Original Installation
>_Alteration/Addition/Repair
Revised 11/95
APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side)
TYPE OF BUILDING
IS THIS APPLICATION ASSOCIATED WITH A
X RESIDENTIAL BUILDING PERMIT APPLICATION YES / NO
BUSINESS
ASSEMBLY CURRENT USE AND OCCUPANCY L- i.?C -, I,
MERCANTILE n
EDUCATIONAL FUTURE USE AND OCCUPANCY �-
INSTITUTIONAL
FACTORY
STORAGE ENGINEER'S NAME PHONE•
GARAGE
MIXED USE ADDRESS
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD AloAJ - CTi4L/c-- Ty,CD C.aG'L.�
SIZE OF MAIN FEEDERS AND RATING OF WIRE USED
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS REMOTE DISCONNECT REQUIRED 7 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
SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
7-4 L L, ,L 4� Q t,r �T; i ,�rS .�r v r 7-6-,*-tS
.!2 �2Ln, ku,h 92L5A A 1,b
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS
TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE O ONN. BUILDING CODES IN THE
PERFORMANCE OF SUCH WO
NAME STATE LICENSE NO. TYPE SIGNATOAZOIF APPLICANT
PHONE NO. DATE �� g