HomeMy WebLinkAboutELEC-6-10-8354 Electric Appl.tif JUN,15.2010 5,19PM ELECTRIC SERVICE 828 327 - 7893 N0,7948 P. 1
(828) 465 -8399 office Number L•dtdWUd L Uul sk FAX =CALL LI vvi I ri iSSUCU rERMIT #
(828) 4654962 Newton Fax Number Application for Perm' TO THIS NUMBER ( °l 7 — �1c��f
(828) 322 -6814 Hickory Fax Number ty i � Y Ltj � I
(Please print or type) f P.0 Box 389 Newton, NC
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TVpe of Permit !(Electrical E] Plumbing ❑ Mechanical ❑ Fire Date
Active Building ( Mobile Home Permit # _ _ Property ID # (if known)
* If no active Building or Mobile Home permit please fist driving direct'ons from a major intersection:
7� ch i/le, RQ� EG2tJ�
Use of structure: ❑ Utobilo Hone ❑ Single family ❑ Multi tamlly ❑ Commercial ❑ Industrial/Factory ❑ Church Owned ❑ Gov't Owned ❑ Accessory
Physical 911 Address of Project -/W O /1/, C�<7'0r %
Ownar or Business - f`yl C Telephone 3/ i � -
Address L ) K) (' qm. --e r -5
Subcontractor ,/ lsrXL47 6_1� VP Telephone
Address ) `� �� fl/t�✓ 2
License # - I0( �'� 6 t
General Contractor
Design Professional Telephone
Address NC Reg #
ELECTRICAL Panel n 1 Amps Panel n 2 Amps Panel # 3 Amps Panel # 4 Amps
❑ New Panel ❑ Pole Service kWire Mechanical unit only (No Svc Chg) Total#
❑ Sub Panel ❑ Service Change Amps_ ❑ Interior Wiring (No Service Change)
❑ Saw Service D Load Control ❑ Modular Home
❑ Sign Service ❑ Mobile Horne ❑ Other (Llsf)
List each panel installed separately' ❑ RV Service T,,1 n..... D
PLUMBING
❑ Full or Partial Bath/Toilet Rooms. (Includes future.) [] Fire Sprink
Total number being installed ❑ Gas Line /F / / �✓ /)
❑ ❑
Mobile home (new set -up only) Modular Ht
❑ Water Heater (Electric, Gas) ❑ Other (List; `l �► / J
MECHANICAL (Check One ) ❑ New InstallatiDii t❑ ChaF age out exiting syster l
❑ Heat _Pump or Furnace with A/C Total #_ ❑ Gas Line/
El Furnace (Oil, Gas, or Electric) Total # ❑ Gas Logs
❑ Air Conditioner Total # ❑ Unit Heate
❑ Water Heater (Electric/Gas) Total # _ ❑ Modular H
FIRE (Check permit type applicable)
❑ Fire Extinguishing System ❑ Compressed Gases
❑ Fire Alarm/Detection System ❑ Hazardous Materials
❑ Fire Pumps & Related Equipment ❑ Industrial Ovens
❑ f=lammable & Combustible Liquids ❑ PVT Fire Hydrants
— All fees entered by Permit Center, DOUBLE FEE charged for work started prior to obtaining permit. "The undersigned makes application for
permits and inspection of work described, and agrees to comply with all applicable State, County codes p laws regulating the work.
PRINT NAME V UJ SIGNATURE
(Subcontractors U License Hn ' wner
0: \BLD\Web Page Bl& Sr z & permit ctr \B!=k Applications \2004 -OS TRADaAppLNEWREVJ D,DOCCreazed on 05/0912005 1:07
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