HomeMy WebLinkAboutElectrical Permit 12. 272 I iiiiis CITY of 2( ` " / 272..
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Transient Operation Permit
I am the owner /agent of the described equipment and hereby request inspection of the electrical wiring
Date(s) of Inspection Requested Time of Inspection Permit #
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Address of Inspection - Street or L ation Cit County
Event
44 ii Z.. WIN r Dig ie<
Equipment Agent/Owner Name
Celik&M or Comigifes.-
Owner Mailin_g Address - Street City � �� /
State ZIP
A
Owner /Agent Telephone Number(s) - Include Area Code(s) Owner /Agent E -ma' Ad s 610 rwyogo
Owner /Agent is ature Title ,p
IF 4
Fee Calculation
Name or Type of Equipment Equipment Identification Number Amps Fee ee
403 •
( ) Re- Inspections @ $35 each
(A ) hours @ $80 per hour e r e tit
fi .f 99
Total $
Operators are subject to an additional $100 fee if the Department is not notified at least 48 hours in advance of each setup.
The operator /agent must notify the Department at least 48 hours in advance of any engagement that is canceled or the fee is forfeited.
A service charge of $30 will be added for all dishonored checks.
Inspection Date(s) Inspector ' ature(s) Inspector Number(s)
61.0/6- Art