Electrical Permit fillable

Town of Waterford, CT – Building Department      
Electrical Permit Application                                           
Estimated Cost: 
 
Permit #: 
 
Fee: 
 
Property Address: 
 
Owner: 
 
Owners Address 
 
Phone # 
 
Residential    Commercial   
New   Repair or Replace  
Service  
Phase: 
 
Voltage: 
 
Amps: 
 
Master Electrician: 
 
CT License #: 
 
Address: 
 
Phone #: 
 
Electrician’s Signature: 
 
Date: 
 
Owner’s Signature: 
 
Date: 
 
Work to be Performed: 
 
 
 
 
 
 
 
 
Rough Inspection: 
 
Final Inspection 
 
The above signed, hereby applies for a permit to do work according to the above specifications.  All provisions of the Building Code shall be complied with in the installation 
of this work whether specified herein or not.  The Electrical Inspector at his discretion may revoke this permit.  It is the applicant’s responsibility to schedule required 
inspections. 
 
 
SIGN
SIGN