Permanent Service

Permanent Service for a New Business

Please use this form to request service for a newly-constructed business facility.

Also see information on our Requirements For Electrical Service.

Customer Information

Email address:

Customer name:

Is this a legally registered name?

Additional customer name (store #, asset#, etc.):

Site address:

City:

State:

Zip:

Directions to site:

Mailing address:

City:

State:

Zip:

Federal ID Number:

DUNS Number:

Customer contact name:

Cust. contact day phone:

Cust. contact pager number:

Cust. contact cell phone:

Cust. contact pager email address:

Cust. contact evening number:

Cust. contact fax number:

Cust. contact email address (if different from above):

Contractor Information

Email address:

Contractor name:

Company name:

Contractor mailing address:

City:

State:

Zip:

Contact day phone:

Contact pager number:

Contact pager email address:

Contact cell phone:

Contact evening number:

Contact fax number:

Contact email address (if different from above):

Preferred method of contact:

Building Data

Type of business:

Square feet:

Operating hours/day:

Operating hours/week:

Operating days/week:

Electrical Service Requirements

Service type:

Requested voltages:

Service entrance capacity (amps):

Number of conduits:

Conduit size:

Number of conductors:

Conductor size:

Neutral size:

Electrical plans available:

Multiple meters with identical load:

Unit identifier:

Expected ready date:

May 2014

New Connection Load

	Single-Phase	Three-Phase
Heat pumps (tons):

Supplemental heat (kW):

Air conditioning (tons):

Electric resistance heat (kW):

Ventilation (kW):

Standard water heating (kW):

Booster water heating (kW):

Computers (kW):

Ovens (kW):

Fryers (kW):

Grills (kW):

Other cooking (kW):

Refrigeration (kW):

Motors (H/P):

Miscellaneous (kW):

Welder in use:

Lighting

	Indoor	Outdoor
Fluorescent (kW):

Sodium (kW):

Metal halide (kW):

Incandescent (kW):

Peak Load Data

Total connected (kW):

Estimated winter demand (kW):

Estimated summer demand (kW):

Largest Motor

H/P:

Phase:

FLA:

LRA:

Variable speed control:

Type of motor:

Type of starter:

Starts/day:

Operating hours/day:

Operating hours/week:

To be used for:

Largest Compressor

H/P:

Phase:

FLA:

LRA:

Variable speed control:

Learn what you must know about working safely around electrical facilities.

Safety for Contractors

Permanent Service