Electrical Permit Application

Electrical Permit Application
2850 19th Street South
Phone (205) 332-6800
Fax (205) 332-6955

Permit fees:
- Residential minimum $100
- Commercial minimum $101
Project Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Electrical Company Name*
Electrical Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Electrical Company Email*
example@example.com
Electrical Company Phone Number*

Area CodePhone Number
Property Owner Name*

First NameLast Name
Property Owner Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Property Owner Email*
example@example.com
Property Owner Phone Number*

Area CodePhone Number
Is there a building permit associated with this?

YesNo
Permit #:
Property Use
Brief description of job:*

Outlets & Fixtures

	Quantity
Outlets
Fixtures

U.L. Listed Pre-wired Equipment Not Otherwise Shown on Fee Schedule

	Quantity
20 & UnderAmperes
21-30 Amperes
31-60 Amperes
61-150 Amperes
151-300 Amperes
301-400 Amperes
400+ Amperes

Main Line Service Switches for lights, Heat or Power (Fee for switches shall include only main line service entrance switches & switches for subfeed panels)

	Quantity
< = 100 Amperes
200 Amperes
400 Amperes
600 Amperes
800 Amperes
1200 Amperes
2000+ Amperes

Low Voltage wiring or installation

	Quantity
Alarms
Telephones
Signaling & CATV Systems
Sensors
Detectors
Stations

Motors

	Quantity
< = 5 H.P.
6 - 25 H.P.
> = 26 H.P.

Generators

	Quantity
> = 10 KW
1 - 25 KW
> = 26 KW

Transformers

	Quantity
> = 10 KW
1 - 25 KW
> = 26 KW

Capacitors

	Quantity
> = 10 KVAR
1 - 25 KVAR
> = 26 KVAR

Dimmers > 1000 Watt

	Quantity
1,000 - 5,000 Watts
5,000 Watts

Fuel dispensing

Quantity

1 Unit per hose
Signs

Quantity

Wiring

	Quantity
1 Unit per hose

	Quantity
Wiring

Wiring for and/or installation of Heating Appliance, Ranges, Ovens, Cooktops & Water Heaters

	Quantity
Heating Appliance
Range
Ovens
Cooktop
Water Heaters

Temporary/Permanent Power

Quantity

Specify Amps

	Quantity
Specify Amps

Cost of Project*
E-Signature*

First NameLast Name
State of Alabama Electrical License number:*
Today's Date*

MonthDayYear
Date
*By signing your name electronically on this form, you are agreeing that your
electronic signature is the legal equivalent of your manual signature.
Should be Empty: