Iowa Electrical Service Inspection Release Form

Complete this form to report electrical service inspections.

Required

Service Address (Where meter is located)

Town/City, State

Tip: Start typing the name of the community in the box above.

Project Name

County

Is the project within city limits? Yes No Unknown

Service Voltage

Service Size

Number of Phases Single Three

This release is for Temporary Permanent Rewire Rehook

Inspection Passed Yes No

Permit Number

Permit Holder's Name

Permit Holder's Phone

Inspector's Name

Inspector's Phone

Inspection Date (MM-DD-YYYY)

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