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2. 
3. 
   City of Edna
   CODE ENFORCEMENT
   126 West Main Street- Edna, TX 77957
   Telephone 361-782-3122
   Fax 361-782-2093
5. ELECTRICAL PERMIT:
7. Permit Date*
9. Location:
10. Building Type
12. Owner:
13. Used For:
15. City*
16. State*
17. Zip*
21. ELECTRICAL PERMIT FEES: METER LOOP
22. $25.00
24. IN ADDITION:
26. Temporary poles / each $5.50
27. Quantity*
28. Amount*
30. Each Circuit:
    Fixture, motors, services, amperes $2.50
31. Quantity*
32. Amount*
34. Appliances
    Range, hot water heaters, dryers, dishwaters, disposals, etc. $2.50
35. Quantity*
36. Amount*
38. Equipment
    Moving picture projector, x-ray, welding machine, transformer type, gasoline pump, elevator, etc. $2.50
39. Quantity*
40. Amount*
42. Signs
    Per transformer, each socket $2.50
43. Quantity*
44. Amount*
48. COMMERCIAL FEES
50. 200 AMP SERVICE

    ---
51. $75.00
53. 400 AMP SERVICE

    ---
54. $150.00
56. 600 AMP SERVICE

    ---
57. $175.00
59. 800 AMP SERVICE

    ---
60. $250.00
62. REMODELING SERVICES

    ---
63. $50.00
65. 
    TOTAL PERMIT FEE

66. ---

    *
68. Please Read and Accept*

    1. I Have Read and Accepted The Terms and Condition
70. Signature of Applicant*
71. Date*
    Date
75. INTERNAL USE ONLY
    City Cashier/Signature: ____________________________
    
    Electrical Contractor:_______________________________________ Phone: ___________________
    
    Inspection Requested Date: ___________________ Time: ____________
    
    List Type of Inspection: _________________________________________
    
    Passed Inspection: ___________ Unsatisfactory: ___________
    
    Comments:__________________________________________________________
    
    Signed By: ____________________________________
    
    City Inspector: _______________________________ Date:________________________
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