Village of Saukville
Electrical Permit Application
Administered by:
Village of Grafton Inspection Department
860 Badger Circle, Grafton, WI 53024-9436
p (262) 375-5305 f (262)375-5312
tjohnson@village.grafton.wi.us
JOB ADDRESS: ___________________________________________________________________
Type:
Residential
New
Commercial
Alteration
Industrial
Addition
Exempt
PROPERTY OWNER INFORMATION
Property owner’s name: _____________________________________________________________
Address of owner (if different than job address): __________________________________________
City/State: _________________________ Zip: _____________ Phone: ______________________
If Applicable:
Lessee name: _____________________________ Address: _______________________________
City/State: _________________________ Zip: _____________ Phone: ______________________
CONTRACTOR INFORMATION
Business’ name: ____________________________ Address: ______________________________
City/State: _________________________ Zip: _____________ Phone: ______________________
E-mail address: ____________________________________________________________________
License holder: _____________________________Village Electrical License #: _______________
(Please submit the separate Contractor Information Form, if not already on file.)
Description of work: ______________________________________________________________
Value of Electrical work: $__________________________________________________________
PLEASE COMPLETE & TOTAL PROJECT/FEE INFORMATION ON REVERSE SIDE
I hereby certify that all statements, forms, and attachments submitted hereto are true and correct to the best of
my knowledge and belief:
Name of applicant (please print):______________________________________________________
Applicant’s signature: ___________________________________ Date: ____________________
**Request for inspections will not be scheduled unless the permit number is supplied at the time of the request**
CD
01
ITEM (CIRCLE IF APPLICABLE & INDICATE NUMBER)
Quantity X Fee = TOTAL
Switches & Outlets_______, 02 Incandescent Light Fixtures______, ______________________________ .60/ea___________
03 Lighting: Mercury ____, Sodium ____, MI ____,_______________________________________________5.00/Fx___________
06 Fluorescent Lamps per Section________________________________________________________________2.50 ea__________
07 Reballasting/per ballast___________________________________________________________________ 1.00/ea___________
08 Appliances - Dshwshr ____, Dispsl ____, Sump Pump ____, Whrlpool____, Tub____, Jacuzzi ____, Range____,
15 Oven____, Cook Top____, Dryer____, Water Htr____,__________________________________12.00/ea___________
20 Furnace____, Boiler____, Unit Heater______, etc______________________________________________ 15.00/ea___________
21 Air Conditioning - Sleeve______, Central Air______, PATC_____, to 3 Ton____ __________________ 20.00/ea__________
24 Cost per ton after 3 Ton (Max. 50 Ton)_______________________________________2.50/ton___________
25 RTUs 0-5 ton ______$50.00 ea, 6-25 ton______$75.00 ea, 26+ tons______$125.00____________________
28 Fans: Bath____, Kitchen____, to 1/2HP etc.____________________________________________________ 5.00/ea__________
30 Low voltage systems: Doorbell____, Switching Sys____, Detector____, Fire Alarm____, etc._____________ 2.00/ea___________
34 Refrigeration – Per rack - vertical___________________________________________________________25.00/rack___________
35 Per section - horizontal____________________________________________________5.00/sec___________
36 Electric Heat - per Kw____________________________________________________________________ 5.00/ea___________
37 Fuel Pumps per product dispensed at Island___________________________________________________50.00/ea___________
38 Bus duct systems__________________________________________________________________________1.00/ft___________
39 Generator_______ $50.00 ea,
40 Transformer & Capacitor___________ $20.00 ea,___________________________________
41 Motors - Max. 5HP______________________________________________________________________ 6.00/ea___________
42 Per HP over 5HP_________________________________________________________________15.00/ea___________
43 Signs – Incandescent / Fluorescent Sign – first section________________________________________25.00_________________
44 Incandescent / Fluorescent Sign – Additional sections________________________________ 5.00/add. sec.___________
45 Neon & like -
____________________________________________________________________25.00 per sign____________
46 Neon & like - _______________________________________________________________plus 4.00/trns___________
47 Fire Alarm Systems – 1st Panel ______$50.00 ea, Additional panels_____25.00/ea,____________________________________
49 Devices: Horn/Strobe____, Detector____, Pull Station____, Test switch_____,_______.60/ea___________
53 Services - New or Change per Meter (includes Temporary Service or any components) 0-100 AMP_____ 40.00 ea,
101–200 AMP______50.00 ea, 201-600 AMP______75.00 ea, 601 & greater_______125.00 ea,___ TOTAL___________
57 Meter Equipment_______________________________________________________________15.00/ea___________
58 Sub Panels ____________________________________________________________________30.00/ea__________
59 Feeders 50 amp & greater_________________________________________________________________25.00/ea___________
60 Medical Equipment_____________________________________________________________________50.00/ea___________
61 Power Outlets above 120 Volts/20 amp______________________________________________________10.00/ea___________
62 Outdooor Lighting per Pole______________________________________________________________25.00/pole___________
63 Trenching Minimum_____________________________________________________25.00______________
64 Trenching – First 100’___________________________________________________25.00 ______________
65 Additional footage ______________________________________________________.50/ft ____________
66 Swimming Pools Above Ground___________________________________________________________30.00/ea___________
67 In Ground / Grid________________________________________________________25.00_____________
68 Pool Light fixture________________________________________________________15.00/ea___________
69 Reinspection__________________________________________________________________________ 50.00_____________
70 Inspections - After Hours_______________________________________________________________ 100.00/ea___________
71 Rewiring, Alterations or Repairs______________________________________________________________ 25.00__________
72 Security Systems – Panel/CPU_____ 50.00 ea + Devices: Detectors_______, Cameras_______, Other______.60/ea _________
76 NEW HOME GROUP (140 - Swit/Out 30 – Fixtures 1 - Dishwasher 1 – Disposal 1 – Sump Pump 1 – Furnace
4 – Fans 7 – Detectors/Doorbell 1 – 200 Amp Ung Service)____________________237.00___________
77 Dimmers,/GFCI/AFCI _______________________________________________________________________ 6.00/ea________
78 MINIMUM PERMIT (Only if above is less than $35)_______________________________________________ 35.00__________
11/11
TOTAL _______________