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 cell phone:

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 cell phone:

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):

Expected ready date:

May 2014

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

Safety for Contractors

Permanent Service