GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS
GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS DEPARTMENT OF PLANNING AND NATURAL RESOURCES DIVISION OF PERMITS STX DISTRICT TEL: (340) 773-1082 STT/STJ DISTRICT TEL: (340) 774-3320 APPLICATION for ELECTRICAL PERMIT Parcel Identification Number (PIN)_________________________________________________________ Owner of the building: ___________________________________________________________________ Owner’s phone number: ________________________ Owner’s email: _____________________________ Owner’s mailing address: _________________________________________________________________ Class of Work: New ☐ Alteration ☐ Addition ☐ Repair ☐ Zone: _________________ Location of Work Use of Building Plot No. Estate Quarter ☐ Private or Rental Dwelling ☐ Store/Warehouse House No. …
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GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS DEPARTMENT OF PLANNING AND NATURAL RESOURCES DIVISION OF PERMITS STX DISTRICT TEL: (340) 773-1082 STT/STJ DISTRICT TEL: (340) 774-3320 APPLICATION for ELECTRICAL PERMIT Parcel Identification Number (PIN)_________________________________________________________ Owner of the building: ___________________________________________________________________ Owner’s phone number: ________________________ Owner’s email: _____________________________ Owner’s mailing address: _________________________________________________________________ Class of Work: New ☐ Alteration ☐ Addition ☐ Repair ☐ Zone: _________________ Location of Work Use of Building Plot No. Estate Quarter ☐ Private or Rental Dwelling ☐ Store/Warehouse House No. Street ☐Restaurant ☐ Bar ☐ Office ☐Other (If Applicable) General statement of the proposed work: __________________________________________________________________ _________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________ Service Entrance: ☐ Existing ☐ Proposed Estimated Current Voltage ☐ 110 ☐ 220 ☐ 440 Type of Structure Conductor Size ☐Underground ☐ Overhead ☐Concrete Block ☐Single Phase ☐ Three Phase Number of Meters ☐Mass Masonry Height of Weatherhead Number of Dwellings ☐Frame No. of Distribution Panels Size of Ground List below circuits to be installed: Circuit No. Voltage Wire Type and Size No. of Outlets Other Loads (Please attach additional sheet(s) if extra space is needed). Total estimated cost of proposed work $ Has work started? The electrician who will do this work: License No.: Signature of Electrician: Date Signed: Mailing address of Electrician: Phone No.: Note: Permit will be issued in the licensed electrician’s name, who is authorized to do the work on behalf of the owner. Seal and Signature of USVI Licensed Electrician