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For office use only: APPLICATION FOR ELECTRICAL PERMIT Permit # ____________________ Sales Doc.___________________ SITE ADDRESS (Premises) Fee $ ____________ USR ______ SUBDIVISION* Paid By_____________________ Lot Number* * For new construction only ELECTRICAL CONTRACTOR Name License # Address Expiration date Phone with area code PREMISES OWNER or TENANT (who gets the power bill). Premises owners who plan to do the work themselves must submit a signed and notarized Affidavit for Owner Electrical Permit with this Application. Name Phone with area code Address DESCRIPTION OF ELECTRICAL WORK GENERAL INFORMATION Building Use Type of Building Single family residence* Unit sq. ft.* Duplex* Residential Apartment Commercial/Industrial Commercial (includes garages/shops) School/Hospital (plan review required) Type of Service Commercial Bid Amount ($) New Existing Overhead Underground UGP (underground service from overhead lines SERVICE INFORMATION Voltage & phase Mobile home Commercial Low Voltage Lighting Retrofit * Building square footage Amperage of service SEE TMC 2.04.240 FOR ELECTRICAL PLAN REVIEW REQUIREMENTS * limited to fixture and/or ballast exchange only All electrical work will be performed by either the Premises Owner or by a licensed electrical contractor . Before applying for an electrical permit, you must pay all engineering and hookup fees for services. These fees will be determined by New Services Engineering (253-502-8436). SIGNATURE OF PREMISES OWNER/ ELECTRICAL CONTRACTOR DATE By signing this Application, the Electrical Contractor hereby certifies, under penalty of perjury, that he/she is the duly authorized agent of the Premises Owner. Print Form FILL IN THE FORM, PRINT & MAIL, FAX OR E-MAIL TO: Tacoma Power Attention: Electrical Inspection 3628 South 35th St., Tacoma, WA 98409 Fax: 253-502-8659 Phone: 253-502-8277 [email protected] Unpaid Permit applications will be discarded by Tacoma Power if payment has not been received within 10 business days of receipt of application.