ELECTRICAL PERMIT APPLICATION Filing Date:* MM slash DD slash YYYY Permit Number: Permit Address:* Street Address Address Line 2 City ZIP Code Phone:*Property Owner:* Email Jurisdiction:* City County Electrical Contractor* CE/Kentucky License #:* ME/Kentucky License #:* 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 Phone*Contractor Email: Electrical Inspector to be used: Residential Permit New Service Extension of Service Change of Service Commercial Permit New Service Extension of Service Change of Service Other Permit Temporary Pole Service Repair Low Voltage Applicant of this Permit hereby understands the following: All work pertaining to this permit shall be inspected by an Electrical Inspector appointed by the City of Hopkinsville or Christian County Fiscal Court. A Certificate of Compliance issued by the Electrical Inspector must be supplied to this office upon completion of the work. Signature* Reset signature Signature locked. Reset to sign again Date* MM slash DD slash YYYY Issued by Electrical Permit Application* Price: Total $0.00 EmailThis field is for validation purposes and should be left unchanged.
