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All Incomplete Applications will be Placed on hold until completed City of Belgrade Application for Residential Electrical Permit I hereby make application for a permit to do electrical work in accordance with all Title 50, Chapter 60, Section 604 MCA and ARM 24.301.431 (Rev. 08/30/2018) Project Address: MT City State Zip Please provide directions to location if not well marked and easy to find: COUNTY: Is job located inside city limits? (circle one) Yes No Property Owner’s Name: Phone Number: Mailing Address: City State Zip Email Address: Electrical Contractor: Contractor’s License Number: Mailing Address for Contractor: Email: Phone Number: Type of Work: ***Please select from the following options – Payment must be submitted with application*** Single Family Dwelling or Cabin (Includes meter base and attached garages if wired at the same time) a. Up to 200 amp service $200 b. 201 to 400 amp service $380 c. 401 to 600 amp service $600 d. 601 amp service and up $800 Single Family Interior/Exterior Wire or Rewire (Remodel/Additions) e. 4+ circuits & change of service &/or interior panel board $120 f. 4+ (no panel board or change of service) $100 g. 2-3 additional circuits or pieces of equipment only $70 h. 1 additional circuit or piece of equipment $45 Residential Change of Service i. Exterior meterbase & interior/exterior main disconnect only $45 j. Disconnect with feeder & distribution panelboard replacement $75 Private Property Accessory Building (Garage, Barn, etc.) k. up to 200 amp panel $80 201 to 300 amp panel… $150 m. 301 or more amp panel… $250 Modular Home, Mobile Home, or RV n. with basement/addition (wired at the same time) $120 o. located on privately owned property $80 p. located on rental space in licensed court with existing service $40 Agricultural irrigation pumps or machines on a common service: q. One pump or pivot $50 for first, $25 each additional r. number of additional pumps or pivots Multi-Family Dwellings (Electrical Contractor must do work and pull permit) (Over 12 units in 1 bldg requires commercial permit) s. Up to 200 amp service $180+60 per unit up to 12 units t. 201 to 400 amp service $380+60 per unit up to 12 units u. 401 to 600 amp service $580+60 per unit up to 12 units v. 601 and up amp service $780+60 per unit up to 12 units w. Rewire/remodel only $100 per unit Mobile Home Courts and/or Recreational Vehicle Parks -Requires Unlimited Electrical Contractor to pull permit and do work x. First 3 spaces (1-3 spaces) $45 y. additional spaces over 3 spaces installed at same time $5 per space Misc Service aa. Livestock wells, residential irrigation wells (new service) ab. Permit Renewal (expiration date can’t be more than 30 day) $60 ac. Requested Inspection $60/first hour *Additional fees at the time of inspection: $30 for each 30 minutes or fraction thereof in excess of one hour, plus travel time. Does this project consist of, or include an Alternate Energy Source? Yes No • If yes, please include an additional $65 fee to the already selected type of work from above table and answer the following questions. (ex. If just installing new solar panels to existing building, select letter from above) • Which type of alternate energy? Solar Wind Hydro • If Solar project, please select one: Micro Inverter/AC Module System PV String System • Does the alternate energy source produce 90 or more volts of electricity? Yes No If energy source produces 90 or more volts, a licensed electrical contractor must do the work – unless the homeowner is doing the work on their own private house**** alternate energy source goes back into the power grid electricial contractor must do work**** Applications must be signed and dated by the homeowner (for homeowner’s private use only) or, if contracted, by a licensed Electrical Contractor person in charge Signature Print Date Make Checks Payable to: City of Belgrade City of Belgrade Public Works, Planning, & Building - 91 East Central Ave. - Belgrade, MT 59714 Phone (406) 388-3783 Power Company: