HomeMy WebLinkAbout06080115 Application
City of Carmell Clay .Township
APPLICATION FOR ELECTRICAL INSPECTION
o /.J
CONTRACTOR
INFORMATION:
APPLICANT
INFORMATION:
TYPE of WORK:
PROPERTY
OWNER
INFORMATION:
NAME
E+B PAV/lJ4 Co,
PHONE
FAX
773-<f/32
State
Zip
Street Address City .
~' ,~ 17042. 1U,1)j)A.l(;~,J jJo8USWCLL
NAME
VA V {D
IN
46060
CONTAcr PHONE:
Property Owner
(or agent)
MACHA.LA AMElZ-tGA,J
CoNS()LTt.J4
"* - ,ctE-LD REP Gm
Fog CAR.M~<--
Contractor
Representative
," RESIDENTIAL:..
PROPERTY OWNER NAME(S):
CrT'( OF
CAICM€.L.
281 - 9S-(,3
COMMERGIAL: X., ,.
PHONE:
S712.E.ET DE rr.
oty
state
Zip I
STREET ADDRESS:
STREET ADDRESS (INSPECTION LOCATION): Oty State Zip
INSPECTION Sf. CO/VJIE./Z. OF AJEid ,I( otJAfO 4BOt/T Irr /Z6-#.. -I- lu..tNOIS 5,-
INFORMATION:
DATE OF INSPECrION: TIME OF INSPECrION:
TYPE OF IMPROVEMENT:
o UPGRADE SERVICE: From
to
o UPGRADE PANEL BOARD(S)
o ADDmON, ALTERATION, REMODEL, or REPAIR TO
AN EXISTING ELECTRICAL DISTRIBUION SYSTEM
J{
NEW METER SERVICE (I,e, 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)
MOVING SERVICE FROM OVERHEAD
TO UNDERGROUND?
DYES
o NO
Number of NEW CIRCUITS:
Number of METERS:
o CONNECrION or RECONNECrION TO A RELOCATED
STRUCTURE
COMMENTS or FURTHER LOCATION CLARIFICATION: (Please attach maD of insDection location)
5 Lt<;'t-IT AI2-'DJiVP }2oVN'OAB1><Ji,
/'
/'
,00 for Commercial Inspections; $
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for Residential Inspections