HomeMy WebLinkAbout2555 S Park Dr (2)CITY OF SANFORD ELECTRICAL PERMIT
0,2_194-I
APPLICATION
Permit Number: V J Date:
The undersigned hereby applies for a permit to install the following electrical:
Owner's Name: -ro TP L 'j �2 V/4 C um e,
Address of Job: �Syi+r .
Electrical Contractor: r�-Qe C j Y I c
Residential:
Non -Residential: L/
By Signing this application i am stating that I am in compliance with Citic. of nford Electrical Code.
Applicant's Signature
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State License Number
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: VV
Description of Work:
Application Fee:
$10.00
TOTAL DUE:
By Signing this application i am stating that I am in compliance with Citic. of nford Electrical Code.
Applicant's Signature
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State License Number