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ELECTRICAL PERMIT APPLICATION <br /> <br />Job..~Addr~ss¢2"~,~- /~- 64¢//~,'&¢-¢¢ ¢.,d~ ~,/~ S~ e No Cross Street <br /> P~one ......... ~c7~ .................... <br /> <br /> Phone Address <br /> <br />~i~"~(~ntractor s N~ .... Home auill'Je~ ~ Reg~strat~orl No -1 <br />.~;,~,~'a us~;~---j%,~2_~-'-7-a;,~e~,,~,' ~-~'¢ ~;-~ '~ ' ---~,,'~ ~_~ ' o~o~,p~o;-oheo~'~7~e <br /> · ~- -~-?¢' i __~ZZ -_¢~/C ..... ........ <br />Elecr ¢ an:,~ No Bud ng ~L/Z.. ! ~ Commercial [-] J,,.~..rat~pn.~'~' ! .~elocatiorl b-/ <br /> <br />No,, RESIDENTIAL <br /> <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> <br /> MISCELLANEOUS <br /> <br /> BRANCH C~RQUITS <br /> <br /> Other (as per NEe, and Building Offm~al) <br /> <br /> 30 00 ............... <br /> 50 00 ............. <br /> 70 00 <br /> 20 00 <br /> <br /> 20 00 <br /> 20oo __ -'-_,.,.7~c~,_.----~ '-- .__. <br /> <br />30 00 <br />50 00 <br />70 00 <br />100 00 ............ <br /> <br />20 O0 ................ <br />30 00 ......... <br />50 00 ........... <br />60 O0 <br />80 00 <br /> <br />20 00 ......... <br />20 00 <br />20 0 <br />20 00 ' <br />20 O0 <br /> <br /> 15 00 <br /> 20 00 .__~_'"_~ ¢2 z' <br /> <br /> Reinspectlon Fee ,;, $ 15 00 <br /> FEE <br /> . STATE SURCHARGE <br />Please return COMPLETE APPLICATION <br />with the indicated fee ,,/ 'INVESTIGATION FEE __ <br /> FLEET SURCHARGE <br /> TOTAL <br /> <br /> <br />