City of Rocky Mount Inspection Services
ELECTRICAL PERMIT APPLICATION - NON-RESIDENTIAL
Instructions
: Complete all pertinent fields, then read the information at the bottom of the form. Click the
Submit
button to send the information; click
Clear
to start over.
Applicant Name:
Date:
Project Address:
Subdivision:
Developer:
Telephone:
Property Owner:
Telephone:
Electrical Contractor:
State License #:
Address:
City:
State:
Zip Code:
Telephone:
Project Supervisor:
Telephone:
Description of Work:
Type of Work (check one, then select an option from the list below it); put the fee in the Total Fee box:
New Service
Select one...
1-99 amps - $65.00
100-199 amps - $65.00
200-299 amps - $70.00
300-400 amps - $100.00
Over 400 amps - $115.00**
**Plus $15.00 for each
additional 100 amps
Total Fee
Service Change
Select one...
1-200 amps - $65.00
201-400 amps - $65.00
Over 400 amps - $70.00
Total Fee
Fire Alarm - $87.50
Tentative Final Inspection - $15.00
Construction Saw Pole - $15.00
Unclassified Work - $62.50
Minimum Fee: $65.00
Reinspection Fee: $75.00
Failure to Obtain Permit: $250.00
Extra Inspection Fee - $75.00
(Minimum two hour charge after normal working hours)
Total Fees
Comments:
I hereby certify that all the information in this application is correct and all work will comply with the State Building Code and all other applicable State and local laws, ordinances and regulations. The Inspection Department will be notified of any changes in the approved plans and specifications for the project permitted herein. I further understand that this is
NOT
an authorization to begin work.
Work may only commence after approval and issuance of the permit.
Owner/Applicant E-mail Address:
Daytime Phone: