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Electrical Permit Application14400 S. Coil Plus Drive, Plainfield, IL 60544 Phone (815) 439 -2937 Fax (815) 609 -6114 plainfield -il.org/departments/building March 2013 Page | 1 APPLICATION FOR ELECTRICAL PERMIT The Permit issued on this application will authorize only work specified. Contractor must give complete information as indicated below. Date of Application: ________________ Cost of Installation : $_______________________ Type of Job : Electrical Service Hot Tub Electrical Upgrade Basement Remodel Residential Addition Swimming Pool Other:____________________________ Address:_______________________________________________________________ Lot #: ____________ Owner Name: ____________________________________ Owner Phone: ________________________ Owner Address: ___________________________________City, State, Zip: ____________________________ Who do we contact when permit is ready?________________________________ ELECTRICAL CONTRACTOR INFORMATION Name of company: __________________________________________________________________________ Street: __________________________________________C ity, State, Zip: _____________________________ Direct Phone # or Cell: _________________________Supervising Electrician: ___________________________ Remarks: _________________________________________________________________________________ OTHER CONTRA CTOR INFORMATION (if applicable) Name of company: _______________________________________Direct Phone # or Cell: _______________________ Street: __________________________________________City, State, Zip: _____________________________ I hereby declare that the above and attached information is correct and agree, in consideration of and upon issuance of a Building & Use Permit, to do or allow to be done only such work herewith applied for, and that such premises and its existing and proposed buildings or structures shall be used or allowed to be used for only such purposes as are set forth above or other uses permitted in the district. Print Name: _______________________________ Sign Name: ____________________________ (Owner/Contractor ) (Owner/C ontractor) Permit Approved: ___________________________ Date: ______________ (Electrical Inspector)