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2. Please provide the required information below when applying for a permit:
4. Name of Electrical Company
5. Contact Name
7. CE and ME License Numbers
8. Contractors Phone Number
12. Name of Customer
14. Address
16. City
17. State
18. Zip Code
20. Phone Number
21. Type of Construction (e.g. Mobile Home, House, Commercial, or Industrial)
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23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

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