Electric Permit Please enable JavaScript in your browser to complete this form.If you are preforming any electrical work you will need a permit number for the inspection. Please fill out the form below. General InformationApplicantProperty OwnerContractorApplicant Email *Work will be performed by: *Property OwnerContractorAffidavit for Homeowners Electric Since you are completing the work as the homeowner, your signature below is acknowledging I currently use this location as my primary residence, or am constructing this home as my primary residence. I will personally perform the Electric Work, and I have not been issued a Homeowners' Electric Permit for any location in the State of KEntucky in the last five (5) years. All work shall conform to the Kentucky Residential Code and 815 KAR 8:035 Property Owner's Signature * Clear Signature Project Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateParcel NumberContractor Information (if applicable)ContractorContractor Phone #AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeContractor's Occupational License #Master Electrician #Electrical Contractor #Property Owner InformationProperty Owner Name *Mailing Address (if different from project address)Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeType of structure: *Single Family HomeQualified Manufactured HomeMulti-Family HomeCommercial StructureDetached GaragePole BarnShedOtherOther Structure Type *Is this structure in the Floodplain? *YesNoType of project: *New ConstructionNew Service PanelAleration/RepairAdditionOther General Name Other Other Project Type *Estimated Cost:Submit
