HomeMy WebLinkAbout1400 W 1 St (2)CITY OF SANFORD ELECTRICAL- PERMIT APPLICATION
Permit Number: 2 ' ( `S Date:
The undersigned hereby applies for a permit to. install the following electrical:
Owner's Name: l,!.l X4 / TX A42 7x_ o c U
Address of Job: / Lei h i S
Electrical Contractor: E' < '
Residential: Non -Residential:
Number Amount
Addition, Alteration, Repair (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:
A
Application Fee: 10.00
TOTAL DUE: T0771
By Signing this application I am stating that I am in compliance with City of Sanford Electrical Code.
Applicant's Signature
State License Number