Please include permit number for applications to existing construction projects with approved zoning and/or building permits.
This part must contain complete contractor's information, either the Licensed Contractor's or the Homeowner's. If the homeowner is acting as the contractor, the homeowner must complete Step 2 and Step 3.
I hereby certify I have read, understand, and agree with the conditions outlined herein, and if disconnection occurs due to my non-compliance I authorize the Inspection Dept. and the Service Utility to disconnect the power and hold them harmless from any damages which may result from their actions. In addition I certify that I am the owner or their authorized agent.
By checking, you agree and acknowledge your electronic signature is valid and binding in the same force and effect as a handwritten signature.
This field is not part of the form submission.
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