City of



| CITY OF JERSEY VILLAGE, TEXAS |

|16327 Lakeview Drive, Jersey Village, TX 77040 |

|713-466-2110 (office) 713-466-2140 (fax) |

ELECTRICAL PERMIT APPLICATION

Date of Application: Master Building Permit No.

Project Address:

The undersigned hereby applies for permit to wire ___ story, Residential Commercial Industrial.

Service Size: amps (150 amp minimum). Number of Phases:

Service entrance conductor size: Copper Only

Applicant: (Company)

Mailing Address:

Telephone: Fax: Cell:

Property Owner: Telephone:

Address: City: State/Zip:

FEES

|Qty |Item |Amount/Each |Total |Qty |Item |Amount/Each |Total |

|Temporary Cut-In (TCI) or Meter Loop & Service (MLS) |$25.00 | | |Lighting Fixture |$1.00 | | |

|Service Reconnection |$25.00 | | |Motors,

Ceiling Fan, A/C & Furnace fans |$10.00 | | |

|Receptacles/Switches |$1.00 | | |Exhaust Fan motor |$10.00 | | |

|Range, Cook top, Dishwasher, Disposal, Oven, Dryer |$6.00 | | |Range Vent Fan |$10.00 | | |

|Sign circuit

Including inside signs |$20.00 | | |Central heat |$10.00 | | |

|X-ray machines |$20.00 | | |Solar Photovoltaic Panels &/or Solar Water Heating Systems |TBD | | |

|Festoon Lighting/Streamers,

Per circuit |$20.00 | | |Temporary Power Pole

(Requires Separate Permit) |$30.00

(Flat Fee) |

| |

|Window Air Conditioner |$10.00 | |1 |Application preparation fee |$10.00 |$10.00 | |

|Re-inspection Fee |$50.00 | | |Minimum Permit fee |$70.00 | | |Describe work being performed: TOTAL FEES: $

________________________________________________________________ VALUATION: $_____________

Residential permit expiration is per the Code of Ordinances, Ch. 14, Art. XIII, Div. 2, Sec. 14-352. Commercial is per the 2018 IBC Sec. 106.3.3. No refunds, non-transferable. All fees will be doubled if work commenced before permitting, as allowed by the IRC Sec. R108.6, IBC Sec. 109.4 and as required by Sec. 14-214 (a). It is incumbent upon contractors to ensure that new equipment – vs. replacement work -- is placed > DFE (Design Flood Elevation), which is 18” above BFE, in areas of special flood hazards, as per the 2018 IRC Sec. 322, IBC Appendix G and ASCE 24-05. By signing below, I’m affirming that I have read & understand the City of Jersey Village’s Electrical Code requirements (including local amendments & ordinances)

Submitted by:

Signature Texas Electrical Master License No.

Print Name: e-mail:

Official Use Only

Approved by: Insurance: YES NO Policy Expires:_________________________

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