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CITY OF SANFORD ELECTRICAL PERMIT APPLICATION
Permit Number: ()Z 12Cl — Date:
The undersigned hereby applies for a permit to install the following electrical:
Owners Name: 5Tu a r T
Address of Job: - izL SCu j%,-7G•'E
Electrical Contractor. Sat rord IF`C-1 t''r C
Residential: X 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: <vn % -OwIl/fa ( Y i % v vAlw-'
Application Fee: 10.00
TOTAL DUE: 73-,Fef21
By Signing this application I am stating that I am in compliance with City of Sanford Electrical Code.
Applica is *nature
State License Number