HomeMy WebLinkAbout2412 Palmetto Ave (2)CITY OF SANFORD ELECTRICAL PERMIT APPLICATION
Permit Number: () Z 'I L/
The undersigned hereby applies for a
Owners Name:
Date: 41—J'a 0lk
rmit t install the following electrical:
Address of Job: a(+ ) 1 la. L ,-t 1 ,0
Electrical Contractor: au_n4_-) 7 C( 7
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 MP Service
Manufactured Building
Other:
Description of Work:
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
E 2-O 0 0 d- F 59
State License Number