Electrical Permit Application.pdf

FIXTURES
FEE
QUANTITY
AMT DUE
Temporary Service
$30.00 ea
Permanent Service (1 & 2 Phase through 400 amp)
$35.00 ea
Permanent Service (401 amp through 800 amp)
$50.00 ea
Permanent Service (801 amp and larger)
$100.00 ea
Transformers, Solar Panels, 1 – 25 KVA/KW
$10.00 ea
Transformers, Solar Panels, 26 – 75 KVA/KW
$15.00 ea
Transformers, Solar Panels, 76 – 200 KVA/KW
$25.00 ea
Transformers, Solar Panels, over 200 KVA/KW
$35.00 ea
Motors and Generators, Up to 25 hp, KW, or KVA
$10.00 ea
Motors and Generators, 26 – 100 hp, KW, or KVA
$15.00 ea
Motors and Generators, over 100 hp, KW, KVA
$25.00 ea
Sub Panels and Feeder after the main disconnect
$35.00 ea
Solar Combiners/Inverters
$35.00 ea
Lights, Outlets, Switches, T-Stats
$20.00 per 50
AC/DC Smoke Alarms, Carbon Monoxide (CO) Alarms
Yard Lights and Signs
$5.00 ea
Fuel Oil, Kerosene, LP, NG, and Gasoline Pumps
$25.00 ea
Boiler, Furnace, Control Device & Stationary Appliances
$10.00 ea
Elevators
$75.00 ea
Platform Lifts
$40.00 ea
Fire Alarm Devices
$30.00 per 50
Fire Alarm Main Panel and Annunciator Panels
$50.00 ea
Fire Pumps
$50.00 ea
Base Fee, Except for 1 & 2 Family Residential Dwellings
$40.00 ea
TOTAL FEE -
MAKE CHECKS PAYABLE TO DEPT. OF PUBLIC SAFETY
ELECTRICIAN INFORMATION
LOCATION INFORMATION
VERMONT DEPARTMENT OF PUBLIC SAFETY
Division of Fire Safety
Office of the State Fire Marshal, State Fire Academy and State Haz-Mat Team
firesafety.vermont.gov
Electrical & Fire Alarm Work Notice
Return this completed form and payment to the appropriate Regional Office:
Department Use Only
Site No.
EWN#
Date Paid
Check#
Amount
Waterbury Regional Office
45 State Drive
Waterbury, VT 05671-8200
Phone: (802) 479-4434
Fax: (802) 479-4446
Rutland Regional Office
56 Howe Street, Building A, Ste 200
Rutland, VT 05701
Phone: (802) 786-5867
Fax: (802) 786-5872
Springfield Regional Office
100 Mineral Street, Suite 307
Springfield, VT 05156-3168
Phone: (802) 216-0500
Fax: (802) 885-8885
Williston Regional Office
380 Hurricane Lane, Suite 101
Williston, VT 05495
Phone: (802) 879-2300
Fax: (802) 879-2312
Name of Building/Site:
Physical Location:
(911 Address)
Name of Lessee:
(If a Business)

Number and Street name, City/Town, Zip Code
_
Building Owner Name:
Owner Mailing Address:
Number and Street name or PO Box, City/Town, Zip Code
Owner Phone Number:
Explain the use of this building:
If residential, number of units:
Provide description of the work:
Job Start Date:
Projected Finish Date:
Name of Electrician:
License Number:
Name of Company:
License Expiration Date:
Electrician Contact Number(s):
Email Address:
Mailing Address:
Number and Street name or PO Box, City/Town, Zip Code
Signature of Licensed Electrician:
Date:

The fees assessed for electrical and
fire alarm work notices are set forth
in the “State of Vermont Electrical
Safety Rules”, pursuant to 26 V.S.A.
§ 893(a).

There is a minimum fee of
$125.00 for each re-inspection
for code violations.
A separate work notice must be filed
for each building.
Payment must be included at the
time of submission.
Fire Alarm Installation requires a
plan review submittal, construction
permit application and fee, prior to
installation.
Solar Panel Installation requires a
permit to include; solar panels, sub
panels, solar combiner/inverters,
lights-outlets-switches, stationary
appliances & base fee.