HomeMy WebLinkAbout06080076 Application
City of Carmel/ Clay Township
APPLICATION FOR ELECTRICAL INSPECTION
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NAME
FAX
CONTRACTOR
INFORMATION:
C;1l-1~1 (
Zip
APPLICANT
INFORMATION: Property Owner
(or agent)
1
OR
Contractor
Representative
TYPE of WORK:
.- RESIDENTIAL:"
COMMERCIAl:
PROPERTY
OWNER
INFORMATION:
PHONE:
Ce~UAbv1S
Zip
INSPECTION
INFORMATION:
TYPE OF IMPROVEMENT:
MOVING SERVICE FROM OVERHEAD .
TO UNDERGROUND?
o UPGRADE SERVICE: From
to
DYES
)31 NO
o UPGRADE PANEL BOARD(S)
o ADDmON, ALTERATION, REMODEL, or REPAIR TO
AN EXISTING ELECTRICAL DISTRIBUION SYSTEM
'Ix( NEW METER SERVICE (i.e. Fountain in pond;
f\ Subdivision street or signage lighting; Installation of
new utility services for an area)
Number of NEW CIRCUITS:
Number of METERS: I
o ROW SIGNAL, SENSOR, MONITOR (i.e. Traffic Ugh
PRINT
ATE
o CONNECTION or RECONNECTION TO A RELOCATED
STRUCTURE
COMMENTS or FURTHER
*- \ ~vtc
*- Is l
FICATION: Please attach maD of insDection location)
i
FEES: $ 100.00 for Commercial Inspections; $ 55.50 for esidential Inspections
S:Permlts/Forms/Electrtcal Application Apr 2006
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