Swanson Consulting & Associates Inc.
Inspection Requests
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Inspection Site
Street Address:
City, Town, or Township:
County:
State:
New York
Pennsylvania
Phone:
Owner:
Occupant:
Occupied As:
Pole #:
Permit #:
Building:
New
Old
Section:
Block:
Lot:
Date:
Work Area in Building (Floor #, etc)
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Applicant Information
Applicant Name:
Address:
City:
State:
Zip:
Applicant Phone #
* Required
License #
Utility Job Request #
Electrician:
Electrician Phone #
Utility Provider
Company Name:
Office Location:
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Equipment Information
App for:
Wiring
Service
or:
Ready for Inspection:
Number of Rough Wiring Outlets
Switches:
Lighting
Receptacles
Number of Fixtures
Electric Heat
500
750
1000
1250
1500
1750
2000
2250
2500
2600
2750
3000
Amp. Service
Surface Unit
Dishwasher
Range
Water Heater
Air Conditioner
Dryer
Pump
Oven
Garbage Disposal
Wiring and Controls for
Burner
Amp. Receptacles
Fractional H.P. Vent Fans
Smoke/CO Detectors
Subpanels
Other Equipment
Motors H.P.
Mark Number of Each Size
1/20
1/12
1/10
1/8
1/6
1/4
1/3
1/2
3/4
1
1 1/2
2
3
5
7 1/2
10
15
20
25
30
40
50
75
100
Additional Information:
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