Homeowner'S Electrical Permit Application Form - City Of Bowling Green
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1Filing Date: _____________
City of Bowling Green
Homeowner’s Electrical
Neighborhood and Community Services
Permit Application
707 E. Main Ave
PO Box 430
Office Use Only
Bowling Green, KY 42102‐0430
Please Print Clearly in Ink or Type
Phone: 270‐393‐3676 & 270‐393‐3615
Fax: 270‐393‐3223
Permit #
EL2016‐
PERMIT LOCATION
Permit Address _____________________________ Suite/Unit/Apt __________ Lot # _______ Building # _______
Subdivision _____________________________ Project/Development Name ___________________________________
Property Owner ________________________________
PERMIT TYPE & FEES
Residential Permits
Existing Service
# of Units
Cost Per Unit
Additional Wiring
$50.00
Change of Service or Service Repair
$35.00
Panel Change
$35.00
Is this Permit for Fire Damage Repair?
Yes
No
APPLICANT INFORMATION
Owner Name _______________________________________________________________________________________
Email __________________________________ Phone _____________________ Mobile _____________________
How long have you lived at this residence? _____________
I the Applicant of this Permit do hereby understand the following:
1. I must own and reside in the property listed above.
2. I may be asked questions to determine my ability to successfully complete the stated work.
3. All electrical work must be performed by me as the owner/occupant. No outside help is permitted.
4. It is at the discretion of the Electrical Inspector whether a permit will be granted or denied.
5. Violation of this information will result in permit being canceled. Inspections will not be completed, and owner will be
required to retain the services of a State Licensed Master Electrical Contractor.
6. To the best of my knowledge all information given herein is true.
Signature
____________________________________________________________ Date ______________________________
January 7, 2016
Doc#601614
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