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PERMIT !1
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT 13
Application is hereby : TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
644-2511 Ext. 230
a e g Inspector Application must be printed or typed
1 . LOCATION OF JOB
1'7 9 Koxxx-
FEE SCHEDULE No . Street
0 - $19000 - 10.00 Floor Apt . No.
Over $1,000 - 10.00
2 . OWNER FICK i//V,4 LS dper $1 ,000 or
fraction thereof
3. ADDRESS 1-7 4 170Z5;6JZ r R
sv, wo,Od'oR 0 . 7 4Z
4. APPLICANTU2 12 G-
5 , ADDRESS 5 Cot 6r R a
ft-,xjcck . c- C 6
6. ESTIMATED COST $ "S d .CU O
7 , IS THIS A CONTRACT COST
I _
Yee No
8 . FEE ENCLOSED
3 1
9 . TYPE OF BUILD C :
RESIDENTIAL COMMERCIAL
10. TYPE OF JOB :
Original Installation
Alteration/Addition/Repair
R8 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB 1 --7 Je.4.5x e-r ID/2
NO STREET APT. NO ,
12 . TYPE OF INSTALLATION j 1/j >
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 . NO. 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
35 . REMARKS AND FURTHER DETAILS :
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LICENSE NO.SIGNATURE OF PPLICA DATE
PHONE NUMBER: