UNIFORM CONSTRUCTION CODE (UCC) ELECTRICAL EXEMPTION AFFIDAVIT

Uniform Construction Code (UCC) Electrical Exemption Affidavit

This form may be utilized to satisfy one of the conditions for excluding a dwelling or structure from the electrical construction requirements of the UCC. It should be filled out completely and submitted to the Building Code Official in the municipality in which the dwelling will be constructed. Submission of this form does not satisfy all the requirements of the Act related to this UCC exclusion. Please type all requested information.

Dwelling or Structure Construction Site

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Towwnship/Borough/City Name(Required)

County

Dwelling or Structure Owner Information

Owner Name

Address

Street Address City State / Province / Region ZIP / Postal Code

Phone

Religious Sect(Required)

Email(Required)

Supporting Documents

File

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 1 GB.