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CITY OF SANFORD ELECTRICAL?PERMIT APPLICATION
Permit Number' V 2 1 O u Date' v
The undersigned hereby applies for a permit to install the following electrical:
Owner's Name: 7 I zov c4 tiv\ 901 C
Address of Job: 01 m C 1- ja
Electrical Contractor: t( iti —Ly. `rri eS
Residential: _ C Non -Residential:
By Signing this application I am stating that I am in compliance with City of Sanford Electrical Code.
Applicant's Signature
State License Number