City of Rocky Mount Inspection Services ELECTRICAL PERMIT APPLICATION - 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 - $75.00 Over 400 amps - $80.00** **Plus $11.00 for each additional 100 amps Total Fee Service Change Select one... 1-400 amps - $65.00 Over 400 amps - $70.00 Total Fee Tentative Final Inspection - $15.00 Unclassified Work - $65.00
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: