Loading...
HomeMy WebLinkAbout06020142 Application City of Carmel! Clay Township i APPLICATION FOR ELECTRICAL INSPECTION 8 ~OAO/I./ ( I I \ '- NAME PHONE FAX CONTRACTOR INFORMATION: Street Address ELec-l-r, C''I. (t!:/f;-!err. f7tS€'! f~c. 7J'tY-22-7....-T 9#zz...-,.9 5? / 5" J. ~ t"c4 Ic-a.... 4VF NAME APPLICANT INFORMATION: S~If>J-/2 TYPE of WORK: Property Owner (or agent) RESIDENl1AL:~ PROPER1Y OWNER NAME(S): PROPERTY OWNER INFORMATION: ~~ tNa. STREET ADDRESS: . 3 6 W ({ (JI,.JI'c./~. STREET ADDRESS (INSPECTION LOCATION): INSPECTION h 3 b WI {( 4 iN ,'e f<. INFORMATION: DATE OF INSPECTION: TYPE OF IMPROVEMENT: ~PGRADE SERVICE: From/ll'u to Z-~.::> o UPGRADE PANEL BOARD(S) [AFCI BREAKERS REQUIRED] o ADDmON, ALTERA110N, REMODEL, or REPAIR TO AN EXISl1NG ELECTRICAL DISTRIBUION SYSTEM o NEW METER SERVICE (Le. Fountain in pond; Subdivision street or signage lighting; Installation of new utility services for an area) o ROW SIGNAL, SENSOR, MONITOR (i.e. Traffic Light) o CONNECTION or RECONNECTION TO A RELOCATED STRUCTURE OR City State Zip: I If.,OtY'vJ N 7/62c;'J CONTACT PHONE: I j'/-2Z.~c;/ !. Contractor i Representative ~ COMMERCIAL: PHONE: ,pY.3 '7/9$ city IN State Zlpt c.I' ~ L city 5"'6" t1 3 '2...- State Zip '2.-. Q G ro.-t- L ..Fill'" 6" t1 ~ 2- l1ME OF INSPECTION: ').:0 Q ....:t.e;o MOVING SERVICE FROM OVERHEAD TO UNDERGROUND? DYES p\NO Number of NEW CIRCUITS: Number of METERS: I /tI ...v-fl I :D4111t) l-,ST/e,tfCcf?. PRINT ~2J;/rJ6. AlE COMMENTS or FURTHER LOCATION CLARIFICATION: (Please attach maD of insDection location) FEES: $ 96.25 for Commercial Inspections; . S:Permlts/Forms/Electrical Application Oct 2003 r Residential Inspections