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Electrical Permit

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Please use this form for electrical permit applications.

* Denotes a required field

Property Owner's First Name*

Property Owner's Last Name*

Address*

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Phone Number*

Phone Area Code-Phone 3-Phone 4 ext Extension

Email Address

Fax Number

Phone Area Code-Phone 3-Phone 4 ext Extension

Address*

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Subdivision or Lot #

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