State
State
State
State
[ ] Commercial
[ ] Residential
Fee Qty Total Fee Qty Total
Date
(Continued on Reverse Side of this Document)
Applicant Signature
Grand Total
Credit Card has a 3% Surcharge
Pools, Spas, Hot Tubs
Service
Permit Information
Signs
Appliances
Item Description
Item Description
Application Fee
INSPECTIONS
Application Fee (Extension)
Appliances
Final
Electrical Systems Category Information
Electrical Fee Schedule
SCOPE OF WORK TO BE COMPLETED
[ ] Alter [ ] Enlarge [ ] New [ ] Repair
Air-Conditioning Equipment
Enforcement (working without permit)
Zip Code
City
Permit Application - Electrical
Otsego County Land Use Services Department
Phone: 989.731.7400 1322 Hayes Road, Gaylord MI 49735 Fax: 989.731.7419
www.otsegocountymi.gov
Permit #:
Property Information
Applicant Information
City
Zip Code
Contractor License Name
License #
License Expiration Date
Email Address
Property Owner Information
City
Zip Code
Owner
Phone #
Cell #
Email Address
[ ] Contractor [ ] Owner
Phone #
Cell #
Email Address
City
Zip Code
Generators
Services > 0 <= 200 Amp
Services > 200 <= 600 Amp
Services > 800 <=1200 Amp
Services > 1200 Amp
Services > 600 <= 800 Amp
Branch Circuits and Feeders
Distribution Outlets-Lighting(per25)
Distribution Outlets-Power (per25)
Electric Space Heating
Fire Alarm Systems
Rough
Signs
Pools, Spas, Hot Tubs
Underground
Fire Alarm Systems
General Requirements
Generators
Other
Plan Review
Print
Reset
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signature
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