HomeMy WebLinkAbout06070156 Application
City of Carmell Clay Township
APPLICATION FOR ELECTRICAL INSPECTION'
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PHONE
FAX
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Zip
IN
Contractor
OR Representative
COMMERCIAL:
PHONE:
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State
Zip
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State
Zip
TIME OF INSPECTION:
o UPGRADE SERVICE: From
to
MOVING SERVICE FROM OVERHEAD
TO UNDERGROUND?
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DYES
TYPE OF IMPROVEMENT:
o UPGRADE PANEL BOARD(S) [AFCI BREAKERS REQUIRED]
o ADDmON, ALTERATION, REMODEL, or REPAIR TO
AN EXISTING ELECTRICAL 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
I CERTIFY THAT THE INFORMATION ONTAIN ED
ON THIS FORM IS COMP AND A CU
o ROW SIGNAL, SENSOR, MONITOR (i.e. Traffic Light)
o CONNECTION or RECONNECTION TO A RELOCATED
STRUCTURE "
COMMENTS or FURTHER LOCATION CLARIFICATI N: (Please attach maD of insoection location)
o-t.iJ S~ ~ r..
FEES: $ 100.00 for Commercial Inspections; $ 55.50 for Residential Inspections
S:Pennlts/Fonns/EledrlcaJ Appllcatlon Apr 2006