HomeMy WebLinkAbout106 Country Pl (5)CITY OF SANFORD ELECTRICAL PERMIT APPLICATION
l Date: 4 -11- DZ
Permit Number.
1 The undersigned hereby applies for a permit to install the following electrical:
Owners Name: i9/y ./f+li'i'CC y l3.gY6edY
Address of Job: 1666 CQ()1 7,7_y a(,l e-e
Electrical Contractor. Si9iy rc C'U •jiyC 409- 32Z- I5& Z
Residential: Non -Residential:
Number Amount
Addition Alteration Lepair Residential & Non -Residential
New Residential:
AMP Service
New Commercial:
AMP Service
Change of Service:
From AMP Service to AMP Service
Manufactured Building
Other
Description of Work: -0
Application Fee: $10.00
TOTAL DUE:
By Signing this application 1 am stating that I am in compliance with City of Sanford Electrical Code.
Appli t' ignature
State License Number
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