* For Remodeling, Alteration and New Construction projects ...



Completed Applications must be returned to the Building Dept. for processing

(Allow 3-5 days for processing) Permits will be sent, as designated below, once approved.

Work CANNOT begin on ANY project until the approved permit is on site

24 Hour Minimum Notice required for ALL inspections to be scheduled for first available.

* DRAWINGS MUST ACCOMPANY PERMIT APPLICATIONS *

|ELECTRICAL PERMIT APPLICATION |

| |

|DATE: ___________________ PERMIT TYPE: ( Residential ( Commercial ESTIMATED COST: __________________ |

| |

|PROJECT ADDRESS: ______________________________________________________________________________________ |

| |

|PROPERTY OWNER NAME(S): ________________________________________________ PHONE #: ___________________________ |

| |

|PROPERTY OWNER EMAIL: ________________________________________________________________________________________ |

|WORK TO BE| |

|COMPLETED |( PROPERTY OWNER (Must submit “Homeowner’s Permit Certification” along with this Application) |

|BY | |

| |( CONTRACTOR / DBA NAME: _____________________________________________________________________ |

| | |

| |Address: _________________________________________________________________________________________________ |

| | |

| |Contact Person: ___________________________________________________________________________________________ |

| | |

| |Phone #: _______________________ ( Cell ( Office E-Mail: _____________________________________________________ |

|SEND PERMIT TO: ( Property Owner ( Contractor SEND PERMIT VIA: ( Mail ( E-Mail |

| |

|SQ. FOOTAGE (Area OF WORK): _________________ ( ALTERATIONS ( Addition ( New CONSTRUCTION ( fire restoration |

| |

|Panel / Dist. Center: ( Temp ( permanent / ( ≤100 amps ( 101- 200 amps ( 201- 400 amps ( 400+ Amps |

| |

|GFCI Outlets ( # - ): ( pool / hot tub ( Other: _______________________________ |

| |

|transformer/generator: ( ≤30 KVA ( 31-75 KVA ( 75+ KVA motors: ( ≤ 15 hp ( 16-100 hp ( 100+ hp |

| |

|Electric Signs ( # - ): ( ≤100 sq.’ ( 100-500 sq.’ ( 500+ sq.’ Pole Lighting: # of poles: ____________________ |

| |

|low voltage: ( ≤20,000 sq.’ ( 20,000+ sq.’ / ( Security ( Speakers ( Coaxial ( Communications ( Temp. Control |

| |

|( Fire Alarm - State Fire Alarm Cert. #: _________________________________ |

| |

|MISCELLANEOUS ( # - ): ( Equipment ( Machines ( CRANES ( Temp. Wiring |

| |

|DESCRIPTION OF PROJECT:_________________________________________________________________________________ |

| |

|__________________________________________________________________________________________________________ |

| |

|__________________________________________________________________________________________________________ |

| |

|__________________________________________________________________________________________________________ |

|The undersigned states that he/she is the owner of the property or authorized agent contracted by the owner of the property. This permit will be granted on |

|condition that all work done will be in accordance with the City of Brook Park Ordinances and all Building Code Laws of the State of Ohio. Failure to comply will |

|result in revocation of this permit and additional fines/penalties may be imposed. |

|SIGNATURE: | |

-----------------------

OFFICE USE ONLY

Fees: __________

__________

__________

%: __________

TOTAL = $

-----------------------

City of Brook Park Building Department

Thomas J. Coyne Mayor

6161 Engle Road

Brook Park, Ohio 44142

P (216) 433-7412 vð ðF (216) 433-4117

ent

Thomas J. Coyne Mayor

6161 Engle Road

Brook Park, Ohio 44142

P (216) 433-7412 ϖ F (216) 433-4117

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