HomeMy WebLinkAbout06070110 Application
City of Carmel! Clay Township
APPLICATION FOR ELECTRICAL INSPECTION
() 60 {J//(}
NAME
CONTRACTOR
INFORMATION: street Address
/5
APPLICANT
INFORMATION: Property Owner
(or agent)
TYPE of WORK: RESIDENTIAL:
PROPERTY OWNER NAME(S):
PROPERTY JSr-
OWNER
INFORMATION: STREET
30 ~~
PHONE
F~
3( ~'1- S-
Oty
State
Zip
IAI
Contractor ~
OR Representative
COMMEROAL: V
PHONE:
.31
Oty State Zip
AVo 4&721.
State Zip
INSPECTION
INFORMATION:
INSPECTION:
TIME OF INSPECTION:
o UPGRADE SERVICE: From
to
MOVING SERVICE FROM OVERHEAD
TO UNDERGROUND?
~NO
DYES
TYPE OF IMPROVEMENT:
o UPGRADE PANEL BOARD(S) [AFCI BREAKERS REQUIRED]
o ADDITION, ALTERATION, REMODEL, or REPAIR TO
AN EXISTING ELECffiICAL DISTRIBUION SYSTEM
.; ~NEW METER SERVICE (i.e. Fountain in pond;
Subdivision street or signage lighting; Installation of
new utility services for an area)
Number of NEW CIRCUITS:
Number of METERS: L
o ROW SIGNAL, SENSOR, MONITOR (i.e. Traffic Light)
o CONNECTION or RECONNECTION TO A RELOCATED
STRUCl1JRE'.'
FEES: $ 100.00 for CommerciallnspectionSi $ 55.50 for Residential Inspections
S:Permlts/Forms/EIectr1caJ Application Apr 2006