HomeMy WebLinkAbout245 Pleasant Valley RoadS
PERMIT
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby:
TOWN OF SOUTH WINDSOR
DISAPPROVED BUILDING INSPECTION DEPT.
644 -2-)11 Ext. 230
Date Building Inspector Applications must be printed or typed.
1
1. LOCATION OF JOB
ez
FEE SCHEDULE
No. Street
C
Floor Apt. No.
0 — $19000 — 10.00 s e
2. OWNER _r m Cam. /(, Gh o /so ,
Over $1,000 - 10.00
per $1,000 or 3. ADDRESS a Y. - /0/cS vw I.
0
fraction thereof
ANT4. APPLIC y°Ce4,!-
r 6LP v
5. ADDRESS 4Y,SO 9c)_I J;va d P
i ACTUAL COST $ FEE $ 6. ESTIMATED COST $_
f
ESTIMATED COST 7. IS THIS A CONTP-ACT COST? (7 YES NOFEE $
FILE COMP. BY BALANCE $ 8. FEE ENCLOSFT) $____
9. IWE OF BUI DING:
RE,-,)TDEN1-TAi COM24MERC IAL
3.0. TYPE. 01 J(16:
0XIGENIAT, ALTEP.A'fIi N
INSTAI.VATTO N ADDITIOti
REPAIR
APPLICATION FOR ELECTRICAL- FfrRA r(Continued icons i:everse Side)
11. LOCATION OF JOB a V9- /0/-
e-sa"f ,-Ae IZ
NO. STREET FLOOR APT. NO.
12. TYPE OF INSTALLATIONe_fu 'c
13. SIZE OF MAIN FEEDER Ce.f
14. NO. OF LIGHT LOOPS 15. NO. OF HEAT LOOPS 16. NO. OF P0v!F.R LOOPS
17. NO. OF LIGHT OUTLETS 18. NO. OF HEAT CIRCUITS 19. NO. OF POWER l.Ll*S
20. NO. OF CONVENIENCE OUTT,,ETS 21. NO. OF HEAT CIRCUITS 22. NO. OF POWER CIRCUITS
23. NO. OF LIGHT CIRCUITS 24. SIZE OF HEAT CIRCUITS 25. NO. OF NO 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. :TAMES OF SUBCONTRACTORS AND THEIR TRADES
35. REMARKS AND FURTHER DETAILS:
0
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LICENSE. NO. SIGNATURE OF PLIC DATE
PHONE NUMBER: