HomeMy WebLinkAbout160 Benedict Drive (6)PERMIT
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DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby: BUILDING INSPECTION DEPTMENT
APPROVED DISAPPROVED TOWN OF SOUTH WINDSOR
236-3231
Date Building Inspector Applications must be printed or typed.
1. LOCATION OF JOB
No. Street
FEE SCHEDULE
Floor Apt. No.
A
1 .00 - $ 200 $3.00
2 01 .00 - $ 600 $4 .0 0 2. OWNERrt, C!
601 -00 - $1000 $6.00
or fraction thereof 3. ADDRESS f" T3 Y i •c rG f _!
4. APPLI CAN'T
5.
sr--
1 ACTUAL COST $ FEE $
w
6. ESTIMATED COST S
i
ESTIMATED COST $
i_ _
FEE $7. IS THIS A CONTF.AC,T.COST? Q" YES Q NO
FILE COMP. BY BALANCE $ B. FEE ENCLOSED
9. TYT' ' OF
Rr:SIUEI 7 T1, C0%,0HERCIAL
10. TYPE OF Jr)6:
ts:tIG I NAI, ALTEFUXTION
JST ti J A 1 Tt"% ADDI rt0\
REP AT h
APPLICATION FOR w LEcPK.LCAI, f'FRdrr(Continued i cow ::evarse Sick')
11. LOCATION OF JOB c2 1.3 e-i ceJr c.- ( r
NO. STREET FLOOR APT. NO.
12. TYPE OF INSTALLATION O C l4_L 1
13. SIZE OF MAIN FEEDER
14. NO. OF LIGHT LOOPS l5. NC. OF HEAT LOOPS 16. INO. OF PC--.•FZ
17. NO. OF LIGHT OUTLETS 18. NO. CIF T icCI"T5 19. NO. OF
20. NO. OF CONVENIENCE OUTLETS 21. NO. OF HEAT C1 KCUITS 22. NO. OF
23. NO. OF LIGHT CIRCUITS - 24. SIZE OF HEAD' CIRCUITS__ 25. NO. OF
26. NO. OF PANELS_ 27. TOTAL, WATTAGE 28. NO. OF PO4ir R PANF;.S_-_
29. NO. OF SWITCHES 30. A/C LOAD.-------- 31. SIZE OF PO'r:ER FEEL)E,S_-
32. NO. OF FIXTURES 33. TOTAL HORSEPOWER_
34. DAMES OF SUBCONTRACTORS AND THEIR TRADES_—_
35. REMARKS AND FURTHER DETAILS:
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE OWNER OF TEI"S PROPt::1TI'
AND WILL BE DONE TN STRICT ACCORDANCE WITH THE BUILDTNG CODE.
LICENSE NO. SIGNGTUI(E OF APPLICANT
PRUNE NUMBER: