TOWN of ADDISON / UNIFORM / Permit #
127 First St., PO Box 481 / ELECTRICAL PERMIT / Tax Key #
Allenton, WI 53002 / APPLICATION / Commercial ☐
PH 262-629-5420 Fax 262-629-5718 / One and Two Family ☐
Project Location
Owners Name- / Mailing Address / Phone # with area code
Contractor’s Name / Contactor’s Mailing Address / Phone # with area code
Contractor’s DSPS Cert. # / Contractor’s email / Fax # with area code
NEW BUILDING OR USE ITEMIZED TABLE

Base Fee …………………………………………………………………………………$50.00$50.00

Plus ………$.07/Sq. Ft. For All Areas Including Basement and Garage ______Sq. Ft. $ ______

TOTAL $______

ADDITIONS, REPLACEMENTS, MODIFICATIONS, AND MISC. ITEMS
EACH QTY COST EACH QTY COST
1. Switches, receptacles and similar devices / $.45 / 15. Air conditioner up to 5 ton. $1.00 per ton over 5 ton / $10.00
2. Power receptacles over 150 volts / $5.00 / 16. Combination heat and AC up to 5 ton. Over 5 ton add $10.00 / $10.00
3. Lighting fixtures-incandescent / $.45 / 17. Elec unit heating device(incl t stat) / $2.00
4. Tubular lamp, per tube / $.45 / 18. Each motor $.50 per HP / $.50/HP
5. Floodlight, search light, mercury light pole base and poles / $3.00 / 19. Dispenser- gasoline, fuel oil, well pump / $10.00
6. Temporary service and wiring install / $25.00 / 20. Each generator, transformer, welder, converter, capacitor, rectifier, / $.50/KW
7. Service up to 200 amps / $40.00 / 21. Feeder, sub feeder and raceway / $5/100 amps
Each additional 100 amps / $10.00 / 22. Swimming pool-wiring & grounding / $25.00
8. Water heater, range, oven, clothes dryer, water pump (each) / $5.00 / 23. Sign-florescent, neon, incandescent / $20.00
9. Dish washer, disposal, / $5.00 / 24. Audible or visual elec. comm. device / $2.00
10. Fans- bath, paddle under 1 HP / $1.00 / 25. Fire alarm system / $15.00
11. Hydro massage and hot tubs / $10.00 / 26. Exit lighting system / $15.00
12. Refrigeration units up to 5 HP- $1.00 per HP over 5 HP / $5.00 min / 27. Approved assemblies not included above / $25.00
13. Photo cells, smoke detectors, clocks / $1.00 / 28. Other (specify) / $25.00
14. Dimmers, rheostats / $2.00 / TOTAL 1 THROUGH 28 / $

Base Permit Fee ………………………………………………………… $50.00 + $50.00_

Re-inspection Fee ………………………………………………………. $50.00 ______

Failure to call for inspection ……………………………………… $50.00 ______

DOUBLE FEE WILL BE CHARGED IF WORK IS STARTED BEFORE PERMIT IS ISSUED TOTAL ______

Building Inspector
JP Building Inspections LLC
Cert. # 1293974
Office 262-629-1744
Cell 262-689-7346
Email / The applicant agrees to comply with the Municipal Ordinances and with the conditions of this permit; understands that the issuance of the permit creates no legal liability, expressed or implied, of the Department, Municipality, Agency, or Inspector; and certifies that all of the above information accurate.
Make check payable to Town of Addison. Mail check and application to Town.
Have address and permit # if available when requesting an inspection. Call the inspector’s office or cell phone # to request an inspection. Please give at least 24 hours notice for inspections.
Signature of Applicant (Electrician) / Date

SUBMIT WHITE AND YELLOW COPIES ONLY-RETAIN PINK COPY AS PERMIT