DEPT. OF BUILDINGS, CODES & INSPECTIONS DIVISION
No. ____________________
APPLICATION FOR ELECTRICAL PERMIT Plan No. ________________
Zone __________________
1. Application is herby made for an ELECTRICAL PERMIT to:
a. Alteration __________
Type of Electrical (Choose One): b. Repair Work __________
c. New Work __________
2. Class or Type of Building (Residence, Commercial, Educational, etc.): __________________________________________
3. Address: ________ 3a. Street: ____________________________ City, ST, Zip_________________________________
4. Owner: ___________________________ Add.& Phone #: _________________________________________________
5. Electrical Contractor: ____________________________________ Address: ___________________________________
5a. City, State, Zip Code: __________________________________________ Phone #: _____________________________
I HEREBY AGREE to act under permit applied for in full accordance with all Laws and Electrical Ordinances of the City of
Tuskegee, and in accordance with the attached Plans and Specifications, and I agree that no work will be done contrary to the
same, else the Permit issued hereunder to be void.
Date: _____________________________ , 2 _______ Signed: ___________________________________
___________________________________________________________________________________________________
Plans and Specifications: No. of Circuits ____________ Used __________ Spare _____________
No. of Light Outlets _________________________________
No. of Switch Outlets ________________________________
No. of Receptacle Outlets _____________________________
No. of Fixtures _____________________________________
Bell Transformer Outlets ______________________________
Total No. of Outlets / Fixtures _________________________
Motors _______________________ H.P. ________________
Main Switch ______________________ Fusing _________________
Meter Loops – No. ________________ Amps Each ______________
Size of Main Wires _________________ Type ___________________
Size of Feeder Wires _______________ Type ___________________
Total Cost Heating Appliances ________________________________________
of Job $ ___________________ Type of Heating __________________________________________
Air Conditioning and Ventilating ______________________________
Miscellaneous ____________________________________________
ACTION UPON APPLICATION BY BUILDING OFFICIAL
THE FOREGOING Application is approved and the same is hereby issued as ELECTRICAL PERMIT NUMBER ___________________
subject to inspections and approval as work progresses.
Date Issued: _______________________________ , 2 ________ Signed: ______________________________________________
Building Official
REPORT OF INSPECTIONS
1. ______________________________ Date _____________________________ , 2 ________ Signed _________________________
2. ______________________________ Date _____________________________ , 2 ________ Signed _________________________
3. ______________________________ Date _____________________________ , 2 ________ Signed _________________________
REVISED 01.24.2008
