HomeMy WebLinkAbout1001 E First StCITY OF SANFORD ELECTRICAL PERMIT APPLICATION
Permit Number: Date: _!r- lO O 2-
The undersigned hereby applies for a permit to install the following electrical:
Owner's Name: I AAJ .:MZ blt', / i71S1it
Address of Job: i O o % E• Iri C..sr Cr. ' .-j-
Electrical Contractor:
Residential: Non -Residential: +,_
Number Amount
Addition, Alteration, Repair (Residential & Non -Residential) 3-c;
New Residential:
AMP Service
New Commercial:
AMP Service
Change of Service:
From AMP Service to AMP Service
Manufactured Building
Other:
Description of Work: A 310 (006np.Sccn.at
ass.m4o
Application Fee: 10.00
TOTAL DUE: 1 3
By Signing this application I am stating that I am in compliance with City of Sanford Electrical Code.
kc,- ICshag Applicant's
Signature State License
Number