Shelby County Electrical Permit
419 Washington Street
Shelbyville, KY 40065
502-633-0692
502-633-7623 Fax
ELECTRICAL PERMIT # ________
Res / Comm: _____
Job Address: ____________________________
City: ____________________________
Type of Construction: _____________________
Attached to Building Permit: _____________
Date Issued: _____________
Contractor: Owner:
_____________________________ _____________________________
_____________________________ _____________________________
City: ___________State: _________ City: ___________State: _________
Zip Code: ________ Zip Code: ________
Telephone #: __________________ Telephone #: ___________________
Contractor License #:____________
Master License #: _______________
COST OF PERMIT: $25.00 TYPE OF PAYMENT: ________________
ISSUED DATE: _______________ ISSUED BY: ________________________
Branch Circuits: Service Amperage:
Single: _______ ______________
Double: ______
Triple: _______
APPLICANT’S SIGNATURE:
No wiring shall be covered up prior
to inspection by the electrical inspector: ___________________________
502-829-0054 / Available MWF 6:30 - 8:00am
Permit Approved: _____________
By: _______________________
All wiring must be done in accordance with the National Electric Code and County Ordinances. All work must be inspected as prescribed by law.
***CALL BEFORE YOU DIG***
IT’S THE LAW!