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HomeMy WebLinkAbout14070118 Application . , �y oF�cay1 Permit# .� � �� RrF c � ��U\RILPi�.�. ;� --°==_= I` City of�CaYme`l/Clay Townsli:ip `�� �°"°��_ ' APPI;I.CATION FOR ELE:CT,RICAL INSPECTION �:i(NDI0.N�� - .._,... .. _. '_ _ .. . _ .. _ . .. � � .NAME� PHONE � FAX CONTRACTOR • INF.,ORMATION: streetaddress ciry, seace iiP . NAME` tONTACTPHONE: APPLICANT 2 :S�l�< � >/' D-✓/�-Y7�:�J, ," /'�0li( /�e,Ij(�n� INFORMATION; property Owne� Gontractor � (or agent) OR: ;Repres,entative TYPE of WORK: RESIDENTIAL• COMMERGIA6: v � PROPERN'OWNER NAME(S)�� PHONEi, PRO,P.ERTY �2, S�Ii,�r LO ' � -l? �7 -G ?J��zoaa AWNER INFORMATION: �E�r`^ooaESS: , cry, state zip - _ � �7,. /�.C�S L✓,c,�l;i'a :si �/o��oov: �✓of�S �,.� /oZay� STREET ADDRESS(INSPEGIlON LOUTION)i� Eiry'. 5[a[e Zlp , INSPECTION `� 0 �. ,(,ye:/,d Sl �f�/%/C /30 �i�/�CC � ��3Z 'INFORMATION: — DATE'OFINSPECTION: � Z3:,�,/ TIMECOF:INSPECTION: �� �f- / TYPE OFIMPROVEMENT;! � Num6er of'NEW CIRCUITS: O UPGRADE,SERVIGE; Erom., to Num6er,of METERS: � O "UPGRADE PANEL BOARD(S) D' ADD1�iION; ALTERATION,'REMODEL, or REPAIR TO AN EXISTING ELECi�RICA��DISTRIBUION SYSTEM' �_NEW METER;SERVICE (i.e Pountain in pond; I�CERTIFY THAT THE INFORMATION CONTAINED $ubdivision street o��signage Iigfiting,,Installation.;of ON_ . O , IS COMF _,E _ ACCURATE. new�utility:services foran area)� , O ROW"SIGNA�; SENSOR; MONITOR��(i:e..Tra�eLigfit) s�q e ` ' O CQNNECTION oE RECONNECTION`TO A_RELOCA_TED o " Oc� ,�i� Z ? � STRUCTURE' P�M ATE' COMMENTS;or_FURTHER LOCATION.CLARIFICATION':_ (Ple"ase'attach'mab':of inspection location) FEES: $°119;00 for CommerciaC.Inspections;; $,65:50 for•Residential Inspections .. . _. _ w. _ 5:\Permitr\FORMS\ACUve forms Binder(Cbpyable'FOrmiOrginals)\Appllcations\2014 ElettdcaClnspectlon'Applica[ion.doc�