HomeMy WebLinkAbout0118489 H
MAR-3-2006 91'59 FRI:JM:¡"¡¡:;SlEY H"'ATING
(9E!Ø) 235-69$1
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Electric Installation Verification
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(Electrical ContmctorName)
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(AddreSS) (City) (State) (Zip Code)
have been. contracted to perform electric in.stalllltion Work forl. ""\ .. ~ '~:~ ~ ~~,
(Nameof,p. yeeD to) ~
atthefoIIowÎngllddress: ~~ ~-:. \:6.............="",~
(Address where work' e Per.funned)
The nature of the work con5ists of: (Check One or Describe the Nature ofWorIc)
L Reconnection or new circuit for replacel!1ent Heating Plant and/or AlC Condenser.
----. Reçonncction or new circuit for replacement Electric Water Heater or power vented
water heater.
- Recol1!J'eCtion ofthe Service Entrance Cable, Meter BQX, alterations to receptacles
JI.11d lighting fixtures due to siding I soffit instalJation. Note; New Service
Entrance Cables wi/J require II separltte pcrn¡it.
- Rcconnection Or new circuit for the rop!accment of o!:h,¡r permanently wired
applial1ces I fixtures.
~ New c:ircuit for the addition of AlC to an individual dwelling llJIit (house o~ the
individual Systems in II duple)!; or condominium). including required service
electrical ol.!tle1:$.
- Other
The value of this work is $ ¿,tf'ø <--
r hereby verify this work will be performed by an employee of this company and further verify
the reconnection I inStallation win be done in COmpliance with manufacturer and Electric code
requirements.
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(Print ~ame of Officer)
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(Date)
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