City of Byron - Electrical Permit Application

Electrical Permit Application
ResidentialCommercialAlteration/Repair
Date*

MonthDayYear
Date
Permit No. *
Estimated Cost of Construction (Laborand Materials): $*
JOB SITE ADDRESS:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
LOT/ SUITE #:*
PROJECT NAME:*
Property Use:*
Zoning District: *
Map and Parcel:*
Job Description: *
Property Owner
Name:
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Trade Contractor
Name:*
State License No.:*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SERVICE INFORMATION
VOLTAGE: *
PHASE: *
AMPS: *
CONDUCTOR TYPE: *
CONDUCTOR SIZE: *
ABOVE GROUNDUNDERGROUND
TEMPORARY POWER POLEPOWER POLECHANGE OF SERVICECHANGE PANEL BOX
OTHER (EXPLAIN) *
SERVICE PROVIDER: *
NUMBER OF CIRCUITS: *
Notice: No changes shall be made from that which is stated in this application, or in attached plans and specifications, except by submitting a revised application, plans and/or specifications and receiving approval of the Chief Building Inspector for such change. Granting of a permit shall not be construed as a permit for or an approval of any violation of the Building Code or any other state or local law regulating construction or the performance of construction. I hereby certify that I have read and examined this application and the information provided herein is true and correct. I further certify that all construction will comply with the Minimum Building Codes.
Signature of Licensed Cardholder or Applicant

Clear
Date

MonthDayYear
Date
FOR OFFICE USE ONLY
Construction Type:
Accepted by:
Occupancy:
Administrative Fee:
Plan Review Fee:
Permit Fee:
CC Fee:
Total Fee:
Inspection Request Guidelines

The following list of information is required in order to schedule inspections . Incomplete information will delay in scheduling an inspection. All inspection requests must be submitted by phone or email by 4pm for next day inspection.

Permit Number

Site Address (please include suite/apt numbers Type of Inspection

Contact name and phone number

Notes (ex. lock box/garage code, call ahead ect.

Email - inspectionsga@bureauveritas.com
Phone number 706-768-0751
Should be Empty:

Electrical Permit Application

Property Owner

Trade Contractor

SERVICE INFORMATION

FOR OFFICE USE ONLY