Form E |
(Regulations 6 and 7) |
Application for an Inspection of an Electrical Installation |
Date ............................................. |
Type of inspection .......................................................................................... |
(State whether new installation, alteration, extension, reconnection or condition) |
Applicant's name ........................................................................................... |
(Block Letters) |
Owner's name ................................................................................................ |
Owner's address ............................................................................................ |
Address and location of installation .............................................................. |
– | ..................................................................................................... |
– | ..................................................................................................... |
(Please give exact details to facilitate location of installation) |
Nature of premises ......................................................................................... |
(i.e. Commercial, domestic, Industrial) |
No. of points ................................................................................................... |
Name of wiring contractor ............................................................................ |
Address of wiring contractor ........................................................................ |
Wiring contractor's licence no .................................................................... |
Wiring Contractor's Certificate |
I certify that the whole/part of the electrical installation has been inspected and tested by me and found to be up to standard. |
................................................................ |
Wiring Contractor's Signature. |
................................................................ |
Applicant's Signature.
|
Date Received | Application No. | Inspection Date |
.................................... | ..................................... | ..................................... |
.................................... | ..................................... | ..................................... |
.................................... | ..................................... | ..................................... |