City of Appleton
100 North Appleton Street, Appleton, WI 54911
Phone: (920) 832-6411 Fax: (920) 832-6464
Permit Fee: $
TO THE ELECTRICAL INSPECTOR
I hereby agree, with the issuance of this permit to do only the work specified herein and to faithfully comply with the laws and regulations of the State of Wisconsin and the ordinances of the City of Appleton.
Customer Number (if applicable):
Name of Owner
Number and Street
Type Of Building
Class of Service
List a brief description of the work and the areas where the work will be conducted:
Call 920-832-6411 for all required inspections.
State Electrical Contractors No:
Licensed Master Electrician:
State/Masters License No:
Daytime Telephone No:
I agree that this permit is not valid until an approved permit is e-mailed back to me. Permit fees are non-refundable.