HomeMy WebLinkAbout2101 E Lake Mary Blvd (2)CITY OF SANFORD ELECTRICAL PERMIT APPLICATION
Permit Number•.Qa - I a C\,- Date: 5 - —o
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The undersigned hereby applies for a permit to install the following electrical:
Owners Name:e-
Address of Job: qz
Electrical Contractor: /I,./-
Residential: Non -Residential: f_
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: — / // f
i t
Application Fee: 10.00
TOTAL DUE:
By Signing this application I am stating that I am in compliance with City of Sanford Electrical Code.
Applicant's Signature
State License Number