HomeMy WebLinkAbout203 Bourbon Street (9)PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT 1dS7,5-
Application is hereby:
TOWN OF SOUTH WINDSOR
APPROVED DISAPPR VED BUILDING INSPECTION DEPT.
644 -2311 Ext. 230
Date Building Inspect Applications must be printed or typed.
1. LOCATION OF JOB
FEE SCHEDULE No. Street
I
II Floor Apt. No.
0 - $1,000 - 10.00
Over $1,000 - 10.00
2. OWNER fs /I
r
per $1,000 or
3. ADDRESS 3 O !? Sfractionthereof r
2 (
I 4. APPLICANT&GJe G
5. ADDRESS
I ACTUAL COST $ FEE $ 6. ESTIMATED COST $
ESTIMATED COST $_ FEE $ 7. IS THIS A CONTR.aC"r COST? LYESQOFILECOMP. BY BALANCE $ 8. FEE ENCLOSED $Zo D Y;-01,V
9. TYPE OF BUI LDINO:
trRiF,")TDENTTAi. C3 CO: iERCIAL
1.0. TYPE 01 J(1li:
0XIGtN,I, ALTERATION
1..! INSTALIATTO)ti ADDITIO`
REPAIR
APPLICATION FOR ELECTRICAL- P68arr(Continued tcont t:eva-rse Side)
11. LOCATION OF JOB_42
NO. STREET FLOOR APT. NO.
12. TYPE OF INSTALLATION,
13. SIZE OF MAIN FEEDER
14. NO. OF LIGHT LOOPS 15. NO. OF HEAT LOOPS 16. NO. OF PC)t..!FR LOOPS
17. NO. OF LIGHT OUTLETS_ _ 18. NO. OF HEAT CIRCUITS 19. NO. OF POWER O',j'rI.L'."S
20. NO. OF CONVENIENCE OUTLETS / 21. NO. OF HEAT CIRCUITS_ 22. NO. OF POWER CIRCLRTS
23. NO. OF LIGHT CIRCUITS 24. SIZE OF HEAT CIRCUITS 25. NO. OF ;I0"'ORS
26. NO. OF PANELS_ 27. TOTAL WATTAGE 28. NO. OF POWER PANELS
29. NO. OF SWITCHES 30. A/C LOAD 31. SIZE OF POWER FEEDERS
32. NO. OF FIXTURES 33. TOTAL HORSEPOWER
34. NAMES OF SUBCONTRACTORS AND THEIR TRADES
35. REMARKS AND FURTHER DETAILS:
61,
PoaZ-
s
1
LICENSE. N0. SIGrATUKE OF APPLICANT DATE
PHONE NUMBER: 51ge'