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Building Placcard Template
VillageOfWappingersFalls
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Building Placcard Template
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8/12/2016 2:12:51 PM
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8/12/2016 2:12:50 PM
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VILLAGE OF WAPPINGERS FALLS <br />PERMIT APPLICATION # ___________________ <br />ELECTRICAL PERMIT APPLICATION <br />APPLICANT : __________________________________________________________________________________________ <br />ADDRESS : _______________________________________________________PHONE : _____________________________ <br />OWNER________________________________________________________________________ <br />ADDRESS : _______________________________________________________PHONE : _____________________________ <br />BUILDER : _______________________________________________________ : ___ <br /> LOCATION : _________________________________________________ <br />DESCRIPTION : <br />___________________________________________________________________________ <br />\[ \] Construction Drawings <br />\[ \] Consent Form from Homeowner <br />\[ \] Insurance /Workes Compensation <br />\[ \] Electrical Inspection Agency: Application Filed <br />Signature of Owner/Contractor/AgentDate Signed <br />Zoning Dept. Use: <br /> FEE : ________________ Deposit : ________________ Balance : ___________________ Total : _________________ <br /> Code Enforcement Officer ApprovalDate <br /> <br />
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