HomeMy WebLinkAbout06090050 Application
SEP-12-2006 TUE 10:55 AM
FAX NO.
P. 02
City of Carmel! Clay Township ::t ~ 6 {J9 ~ 0 f)O .
APPLICATION FOR ELECTRICAL INSPECTION
NAME PHONE FAA
CONTRACTOR M V FARRAR ELECTRIC, INC. 317-545-7155 317-545-7194
INFORMATION: Street POdress Cl!y State ZJp
4830 INDUSTRIAL PARKWAY INDIANAPOLIS IN 46226
NAME CONTACT PliaNE:
AQUATIC SERVICES 317-752-0140 1
APPUCANT
INFORMATlON: Property Owner Contractor I
(or agent) OR Representative XX I
TYPE of WORK: RESIDENTIAL: COMMERCIAL: XX I
PROPEklY OWNER NAME(S): PHONE: I
PROPERTY B H MANAGEMENT SERVICES, INC. 317-848-5100
OWNER ZJp I
INFORMATlON: STREET ADDRESS: CIty SliIte
382 ARBOR DRIVE CARMEL IN 46032
STREE1' ADDRESS (INSPECTION lOCATION): 0", State Zip'
INSPECTION 291 ARBOR DRIVE CARMEL IN 46032
INFORMATlON:
DATE OF INSPECTION: TIME OF INSPECTION:
UTT T r^TJ H)R
TYPE OF IMPROVEMENT:
MOVING SERVICE FROM OVERHEAD
TO UNDERGROUND?
o UPGRADE SERVICE: From
to
DYES
o NO
o UPGRADE PANEL BOARD(S)
o ADOmON, ALTERAll0N, REMODEL, or REPAIR TO
AN EXISTING ELECTRICAL DISTRIBUION SYSTEM
Number of NEW CIRCUITS:
Number of METERS: .-i.-
I CERTIFY THAT THE INFORMATION CONTAINED
ON THIS FO~ COMPLETE AND ACCURATE.
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Slgnatvrt
'/'I\\~~~\ fc-.'tr"'-II
PRINT
q II~/ 01.
DAre
~ 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 Ught)
o CONNECTION or RECONNECTION TO A RELOCATED
STRUCfURE
COMMENTS or FURTHER LOCATION CLARIFICATION: (please attach maD of inspection location)
INSTALLATION OF 100 AMP SINGLE PHASE PEDISTAL FOR POND FOUNTAIN SERVICE
FEES: $ 100.00 for Commercial Inspections; $ 55.50 for Residential Inspectibns
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