HomeMy WebLinkAbout1115 Laurel Ave (2)CITY ON,1
FSAN FORD
Permit Number: '76
ELECTRICAL PERMIT APPLICATION
Date: I 6 I oz "
The undersigned hereby applies for a permit to install the following electrical:
Owner's Name: KY_c-f VAw C
Address of Job: 11 5 LA 0
Electrical Contractor: I,,ZE tL-F-Ct-)ULf NL
Residential: n Non -Residential:
Number Amount
Addition, Alteration, Repair (Residential Non -Residential)
New Residential:
AMP Service
New Commercial:
CAMP Service
Change of Service
m 1 0OAMP Service to AMP Service
Manufactured Building
Other:
Description of Work: Gft-Ao E 6F- SCx,\jl CZ . A c- . fr! f A
MBA t - Application
Fee: 10.00 TOTAL
DUE: By
Signing this application I am stating that I am in compliance with ty of Sanford Electrical Code. Appli
nt's Signature f—(! _
ri0C.)Z(?Z State
License Number