**YOU CAN FIND THIS APPLICATION AND MORE ON THE WEBSITE AT WWW.HARFORDCOUNTYMD.GOV**
JOB
ADDRESS ______________________________________________________________________________________
SUBDIVISION ___________________________________ BLDG.____________ FLOOR ____________ SUITE _________
BLDG. PERMIT # ___________________________________________UTILITY CO. _______________________________
BLDG. USE _________ NEC __________ TYPE WORK ______________________________________________________
WORK DESC. _______________________________________________________________________________________
RESIDENTIAL COMMERCIAL GOVERNMENT AGRICULTURE
OWNER INFORMATION
CONTRACTOR INFORMATION
LIST
ALL ITEMS TO BE INSTALLED INCLUDE SIZE AS REQUIRED
QTY
DESCRIPTION
SIZE
QTY
DESCRIPTION
SIZE
Service Entrance AMP Fixture Incandescent
Sub Feed AMP Fixture Fluorescent
Sub Feed AMP Fixture HID
Sub Feed AMP LED Fixtures
Sub Feed AMP Exit Emergency Lights
Sub Feed AMP Oven KW
Sub Feed AMP Oven KW
Sub Feed AMP Cooktop KW
Generator (
add service or sub feed
size above)
KVA Cooktop KW
Construction Service AMP Range KW
Mobile Home-Pedestal AMP Dishwasher KW
MH-Conn/Reconn AMP Disposal KW
Construction Trailer-Conn/Reconn AMP Dryer KW
Rough Switches Water Heater KW
Rough Receptacles Water Heater KW
**ALL APPLICANTSPLEASE READ AND SIGN STATEMENT AT THE BOTTOM OF PAGE 2**
JOB INFORMATION
OCCUPANT ____________________________________
ADDRESS ______________________________________
CITY ___________________ ST ________ ZIP________
PHONE # ______________________________________
COMPANY _____________________________________
LICENSEE ______________________________________
ADDRESS ______________________________________
CITY ____________________ ST _______ ZIP ________
PHONE # ______________________________________
EMAIL ________________________________________
HARFORD COUNTY LIC. #_________________________
__________
____________________________________
SIGNATURE OF LICENSEE DATE
NAME ___________________________________________
PHONE # _________________________________________
EMAIL ADDRESS ___________________________________
DEPARTMENT OF INSPECTIONS,
LICENSES & PERMITS
ELECTRICAL SERVICES DIVISION
220 SOUTH MAIN STREET
BEL AIR, MD 21014
410-638-3363
410-638-3364
Permit Number:
_____________________________
ELECTRICAL PERMIT
APPLICATION
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QTY
DESCRIPTION
SIZE
QTY
DESCRIPTION
SIZE
Furnace Gas/Oil Heaters Less than 1/8 KW
Furnace Electric KW Heaters >=1/8 KW and < 2 KW
Furnace Electric KW Heaters >=2 KW and < 30 KW
Furnace Electric KW
Heaters >= 30 KW and < 75 KW
Heat Pump AMP Heaters 75 KW and Over
Heat Pump AMP Motors < 1/8 HP
Heat Pump AMP Motors >= 1/8 HP and <2 HP
A/C Units AMP Motors >= 2 HP and <30 HP
A/C Units AMP Motors >= 30 HP and < 75 HP
A/C Units AMP Motors 75 HP and Over
Air Handler HP Motor Control Centers AMP
Air Handler HP Pumps HP
Roof Top Units AMP Pumps HP
Roof Top Units AMP Pumps HP
Roof Top Units AMP Air Compressor HP
Roof Top Units AMP Air Compressor HP
Smoke Alarms Refrigeration Units HP
Carbon Monoxide Alarms Welder KW
Low Voltage Control Panels Welder KW
Low Voltage Devices-Fire X-Ray Machine KW
Low Voltage Devices -Security X-Ray Machine KW
Low Voltage Devices-
Voice/Data
Gas Dispensers HP
Low Voltage Devices-Audio Dental Chairs
Low Voltage Devices-Other Fryers
Transformer KVA
Ditches, Pole Bases and Underfloor
Number of Inspections Required___________
Transformer KVA Parking Lot Lights
Transformer KVA Bonding
Elevators HP Spa/Hot Tub AMP
Solar – Commercial KW Pool Bonding
Solar - Residential KW Pool Wiring
Bath Fans Sign 2000 VA KW
Paddle Fans Sign 7000 VA
KW
Hood Fans HP Vehicle Charger (Subfeed) AMP
Compactor HP Plan Review/Demo HRS
By submitting this application, the applicant certifies and agrees: (1) That the applicant is authorized to make the application because the
applicant is the property owner or an authorized agent of the property owner; (2) That all the information provided is correct; (3) To comply
with all the laws and regulations of Harford County that are applicable to the request; (4) To perform only the work as specifically described in
this application; (5) To grant County officials/employees the right to enter onto the property for purposes of inspecting the work permitted and
posting notices; and (6) currently holds an active license or registration with Harford County Government. In accordance with Harford County
Code §1-22 F, a person who knowingly makes a misrepresentation or false statement on an application for a County permit or license is guilty of
a misdemeanor and, upon conviction, is subject to a fine not exceeding one thousand dollars ($1,000) or imprisonment not exceeding ninety
(90) calendar days or both.
The provision concerning insurance IS NOT applicable to an individual who is a homeowner performing work on his/her primary residence as
provided under the Harford County Code. By signing below, a homeowner performing work on his/her primary residence agrees to fully comply
with all of the applicable provisions of the Harford County Code. I have carefully examined and completed this application to the best of my
knowledge and belief. I will notify the Electrical Services Division 24 hours in advance for inspections. No work will be concealed until approved
and completed in accordance with appropriate County Codes.
CONTRACTOR’S SIGNATURE _______________________________________________ DATE __________________
Rev. 1/11/2019
Application Document No. 000340-2020
R
evised May 2020
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