Project Name (& phase if applicable):                                                                                                                                         

 

Request is for: è                Information Only                           Electric Service Extension

 

Project Address:                                                                                                                                                                               

** Re: Utility Account Number:                                                                                                                                                        

Lot #:                                Block #:                                  Parcel #:                               

 

Type of Service:                                                  Project Engineer or Architect:                                                                           

 Commercial Building                                  Engineering/Architectural Firm:                                                                       

 Industrial Park or Facility                             Telephone: (                       ) -                                                                             

 Retail Center or Building                            Customer Name:                                                                                               

 Residential Subdivision                             Customer Telephone: (    ) -                 

 One Unit Residential                                   Number of Meter Bases:                                                                                   

 Multi Unit Residential                                 

 Other:                                                                                                                                                                                             

 

Service Data:

Main Breaker Size:                                Amps             Service Voltage:                                       Volts

Number of Phases (1 or 3):               

Phase Conductor(s):                                Size,                         Quantity,                                  Material (Cu or Al)

Neutral Conductor(s):                                 Size,                         Quantity,                                  Material (Cu or Al)

Secondary Service Distance (from meter to transformer):    Feet

 

 Underground Requested                                                          Overhead Requested

          Number of Conduits:                        Total                                         Type of Mechanical Attachment to

          Conduit Size:                                                                                        the Building or Structure:

          Number of Conductors per                                                                          Insulated House Knob

            Conduit:                                                                                                          Eye Bolt

                                                                                                                                     Other:                                                         

Electric Load Data:

                  KW, Expected Peak Demand (A) (used for contract demand and transformer size)

                  KW, Total Connected Load (sum of power used, calculated from list below)(B)

                  Diversity Factor Expected (example 70%)(A/B)

 

               Amp   Heat Pump – Compressor                                                Hp      Manufacturing Load

               KW     Heat Pump - Strip Heat                                                      Hp      Largest motor,                      Phase

               Ton    Air Conditioning (not Heat Pump)                                    Amp   Welders (Max),                    Phase

               KW     Resistance Heat (not Heat Pump)                                  KW     Refrigeration Load

               KW     Air Handling (not Heat Pump)                                           KW     Water Heating Load

               KW     Lighting Load                                                                       KW     Cooking Load

               KW     Receptacles                                                                         KW     Future Load

               KW     Miscellaneous

 

Additional Comments or Equipment requiring Special Attention:                                                                                            

                                                                                                                                                                                                               

 

Permanent Service Date:                                                             Temporary Service Date:                                                    

 

Note:      Please contact Community Development for Site Plan/Drawing submittals.

 

Return Completed Document to:                                        Submitted By:                                                                               

City of Oak Ridge Electric Department      Name:              Title:                                            

P.O. Box 1                                                                                 Signature:    Date:                                    

Oak Ridge, TN 37831-0001

----- DO NOT WRITE BELOW THIS LINE -----

Contract Required:  YES  NO                Contract Demand:                      kW         Deposit: $                                      

Staff Comments:                                                                                                                                                                                

Copy to UBO                   **-For office use only, customer does not fill out.

CORED Form 9-0-1, Revision 4, 11/20/2002