Electrical inspection form


Required field=

Municipality:
City Town Village
Municipality name:
Site inspection address:

Permit number:

Inspector:

Inspector phone:
000-000-0000
Inspector cell:
000-000-0000
Inspector e-mail:

Customer name:

Customer phone:
000-000-0000
Electrical contractor:

Electrical contractor phone:
000-000-0000
Inspection date:
Inspection license #:
Service type:
Residential Commercial
Duration:
Permanent Temporary
Subdivision:
Yes No
Overhead
Underground
Size:
amps           volts
Phase:
One Three
Number of meters:
Service type:
Residential Commercial
Duration:
Permanent Temporary
Customer power:
On Off        Reconnect at: Pole House
Overhead to underground
Overhead to overhead
Underground 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: