ELECTRICAL PERMIT APPLICATION (Please complete and be specific. Failure to do so will cause a delay in the issuance of the permit) THIS APPLICATION DOES NOT CONSTITUTE PERMISSION TO BEGIN WORK. IF WORK IS STARTED WITHOUT A PERMIT, AN INVESTIGATION FEE WILL BE ASSESSED IN ADDITION TO THE PERMIT FEE. THE INVESTIGATION FEE SHALL BE EQUAL TO THE PERMIT FEE. NO REFUND AFTER THIS PERMIT LEAVES THE OFFICE THIS PERMIT IS NON-TRANSFERABLE Contractor’s License and Liability InsuranceMax. file size: 5 MB.Scope of Work/Plan DrawingMax. file size: 5 MB.Address / Location of Property Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code LOT No.BLKCBZoneLot Size AgeAn application is hereby made for a permit to cover the following work:New Structure / Residential / commercial / Remodel / Addition / Alteration / Repair / Int. Comp / C of O / TML New Structure Residential Commercial Remodel Addition Alteration Repair Int. Comp C of O TML Solar Panels - Square Footage of area of roof affected by Solar Panels No. RoomsNo. BathsNo. StoriesNo. SwitchesNo. GFCLNo. Outside OutletsNo. Inside OutletsNo. Lighting Fixtureselec range / elec dryer / garbage disp / dish washer / e;ec furnace / elec water heater Elec. Range Elec. Dryder Garbage Disp. Dish Washer Elec. Furn Elec. Water Heater Describe work to be performedExplain the current and/or future use of building or space:Property Owner First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Property Owner Phone NumberContractor First Last Contractor Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code State License No.TOTAL VALUE OF CONSTRUCTION PLUS ALL FINISHED WORK $*All electrical work must comply with the 2014 edition of the National Electrical Code as published by NFPA. THE APPLICANT SHALL BE RESPONSIBLE FOR INFORMING ALL PARTIES INVOLVED, INCLUDING THE DESIGN PROFESSIONAL OF ANY CODE NON-COMPLIANCE AS NOTED ON PLANS. INSPECTIONS REPORTS OR ANY OTHER DOCUMENTS ISSUED BY THE BUILDING OFFICIAL/INSPECTOR. I hereby acknowledge that I have read this application and state that the above is correct and I agree to comply with all City of Kirby ordinances, State Laws, and the International Codes as published by ICC regulating building construction.SignaturePrint First Last Applicant Email(Required) Company First Company Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Company PhoneDate of Application MM slash DD slash YYYY Date Permit issued MM slash DD slash YYYY Permit FeePlan Review FeeInvestigation FeeInspection FeeApproved to issue permitBuilding Official First Last CITY OF KIRBY | 112 BAUMAN STREET KIRBY, TEXAS 78219 | PHONE (210) 661-3198 | FAX (210) 661-4525 Δ
