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Electrical inspection form
Required field=
•
Municipality:
•
City
Town
Village
Municipality name:
•
Site inspection address:
•
Permit number:
•
Inspector:
•
Phone:
•
000-000-0000
Cell:
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000-000-0000
Customer name:
•
Customer e-mail:
•
Phone:
•
000-000-0000
Electrical contractor:
•
Phone:
•
000-000-0000
Inspection date:
•
Inspection certification#:
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New service
Service type:
Residential
Commercial
Duration:
Permanent
Temporary
Subdivision:
Yes
No
Overhead
Undergound
Size:
amps
volts
Phase:
One
Three
Number of meters:
Rewire service
Service type:
Residential
Commercial
Duration:
Permanent
Temporary
Customer power:
On
Off
Reconnect at:
Pole
House
Overhead to underground
Overhead to overhead
Undergound to underground
Size:
amps
volts
Phase:
One
Three
Number of meters:
Details (check all that apply):
Permanent connections made.
Permanent connections required.
Service drop relocations / replacement required.
Additional / new meter install required.
Cogeneration
Solar
Geothermal
Wind
Notes/Remarks:
Send