HomeMy WebLinkAbout2535 El Portal AveCITY OF SANFORD ELECTRICAL PERMIT APPLICATION
Permit Number: 62 " OL
Date: 311110 Z—
The undersigned hereby applies for a permit to install the following electrical:
Owner's Name: /, C, 0 —,Z—
Address of Job: 2 5' 5__ e G P.,o,,,2 C_ /4-
Electrical Contractor:
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:
TL
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
G 29 9'5-
State License Number