New Construction

Name of person submitting this form

Phone number of person submitting this form

Email address of person submitting this form

Project name

Owner's name

Owner's name
	Owner's name First Last	Item weight

more items

Owner's Phone Number

Owner's Phone Number
	Owner's Phone Number	Item weight

more items

Owner's mailing address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Physical service of the address

Address

City/Town

State/Province

ZIP/Postal Code

Legal description

Range-Township-Section-¼ section

Subdivision name-Lot-Block

Other…

Range-Township-Section-¼ section

Subdivision name-Lot-Block

Electrical Contractor

Electrical contractor contact

Electrician's phone number

Wiring Permit

please upload image of wiring permit

One file only.
20 MB limit.
Allowed types: gif, jpg, jpeg, png.

General Contractor

General Contractor Contact

Contractor's phone number

Name of excavator

Name of excavator contact

Excavator's phone number

Date estimate is needed?

Date service is needed

Type of service requested

Residential

Commercial

Irrigation

Heat type

Gas

Total Electric

Voltage

Service Size

Any other comments?

Office Location

Dropbox Location

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