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Permit # _________________________
City of Carmel/Clay Township
APPLICATION FOR ELECTRICAL INSPECTION
CONTRACTOR
INFORMATION:
NAME PHONE FAX
ADDRESS CITY STATE ZIP
DATE OF INSPECTION: ____/____/______ TIME OF INSPECTION: 9-11 10-12 12-2 2-4
STREET ADDRESS: CITY STATE ZIP
RESIDENTIAL: ________COMMERCIAL: ________
Property Owner Contractor
(or agent) ______ OR Representative ______
NAME CONTACT PHONE:
APPLICANT
INFORMATION:
PROPERTY
OWNER
INFORMATION:
TYPE of WORK:
TYPE OF IMPROVEMENT:
UPGRADE SERVICE: From _______ to _______
METER RELOCATION
UPGRADE PANEL BOARD(S)
ADDITION, ALTERATION, REMODEL, or REPAIR TO
AN EXISTING ELECTRICAL DISTRIBUTION SYSTEM
NEW METER SERVICE (i.e. Fountain in pond;
Subdivision street or signage lighting; Installation of
new utility services for an area)
R.O.W. SIGNAL, SENSOR, MONITOR (i.e. Traffic Light)
CONNECTION or RECONNECTION TO A RELOCATED
STRUCTURE
MOVING SERVICE FROM OVERHEAD
TO UNDERGROUND?
YES NO
Number of NEW CIRCUITS: _______
Number of METERS: ______
I CERTIFY THAT THE INFORMATION CONTAINED ON THIS
FORM IS COMPLETE AND ACCURATE.
SIGNATURE
PRINT DATE
COMMENTS or FURTHER LOCATION CLARIFICATION: (Please attach map of inspection location)
__________________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________
FEES: $127.00 for Commercial Inspections; $70.00 for Residential Inspections
PROPERTY OWNER NAME(S): PHONE:
STREET ADDRESS (INSPECTION LOCATION): CITY STATE ZIP
INSPECTION
INFORMATION:
Frye Electric Inc 317-271-1099 317-271-1499
8403 E US HWY36 SU B AVON IND 46123
Pam Crew 317-469-6009
X
Pam Crew 317-469-6009
11102 Timber Ln Carmel IND 46032
SAME as Owner
X
X
4
1
Convert the existing 200 amp service to under ground, replace the 200 amp panel, add a new
100 amp sub panel in the detached garage, add (2) lights, Garage door receptacle, (6) Duplex
Receptacles
Gregory L Wells 9/25/2019