Employee Number:
SAP#:
Project Service Date:*
Project Type:*
--Select One--
Single Family Residential
Apartment/Condo
Commercial
Other
Project Site Hazard:*
--Select One--
None
Dog
Vicious Dog
Site Access Instructions:*
--Select One--
Locked Gate
Locked Fence
None
Service Address:*
Parcel Number:*
Cross Street:
Thomas Brothers:
Service Request Type:*
--Select One--
Electric
Gas
Electric & Gas
For whom is this work to be performed?
Name:*
Email Address:
Phone Number:*
Mailing Address:*
Mailing Address will be the same as the Service Address
Customer Type:*
--Select One--
Owner
Tenant
Other
Name:*
Email Address:*
Phone Number:*
Cell Phone Number (Optional):
Fax Number (Optional):
Owner will be the contact person
Mailing Address:*
Contractor Type:*
--Select One--
Electrician
Plumber
Gen'l Contractor
Customer Representative
Customer or Tenant
Solar Company
Solar Contractor
Other
Project Scope:*
--Select One--
New Service
Service Rewire/Upgrade
Temporary Service
Temporary Service/Permanent Base (TSPB)
Service Removal/Bldg. Demolition
OH to UG Conversion
Disconnect/Reconnect (JT Meets Reqs.)
Other
Existing Service Type:*
Overhead
Underground
Meter Number:
Transformer Number:
Approximate Building Area:
Voltage:*
--Select One--
120/208
120/240
240/480
277/480
480
Unknown
Existing Panel Size:*
Phase:*
--Select One--
100
125
200
225
400
600
800
1000
1200
1600
1800
2000
2500
3000
3500
4000
Other
--Select One--
Single
Three
New Panel Size:*
Phase:*
--Select One--
100
125
200
225
400
600
800
1000
1200
1600
1800
2000
2500
3000
3500
4000
Other
--Select One--
Single
Three
Add All Applicable Load Data:
--Select One--
Lights
Range
Heat
Water Heater
Dryer
Electric Vehicle
Solar
Elevator
Largest Motor
Well Pump
Air Condition
Other
Service Type:*
--Select One--
New Service
Service Relocation
Service Removal
Raise/Lower Meter
Propane to Natural Gas Conversion
Other
Requested Service Pressure:*
--Select One--
1/4##
5##
2## Multi Family Residential High Rise
Meter Number:
Add All Applicable Load Data:
--Select One--
Cooking
Space Heater
Water Heater
Pool Heater
Spa Heater
Boiler
Dryer
Log Lighter
Barbeque
Tankless AWH
Non-Core Srv
Fuel Cell
Other
Comments:
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