Purchase an Electrical Permit


Job Site Information - * Indicates required fields
Applicant
Site owned by *
Mailing Address
Address *
City *   State *   Zip *  
Phone * - -   Ext.   999 999 9999 Ext. 99999
Fax - -   999 999 9999
E-Mail *   xxx@xxx.xxx
Enter Site Information - Accurate information below will aid the L&I Inspector in conducting the inspection
Site Address   Check if job site address is the same as the mailing address above.
SiteAddress *
Site Zip Code * Zip *     City *     State
Site Phone * - -    Ext.    999 999 9999 Ext. 99999
Within City Limits *
County (L&I Office) *
Work Description *
Driving Directions(from nearest main crossroad) *