HomeMy WebLinkAbout06100075 Application
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City of Carmel/ Clay Township# () 6 (0001'"51
APPLICATION FOR ELECTRICAL INSPECTION
CONTRACTOR
INFORMATION:
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Clty
FAX
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State
Zip
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Contractor
Representative ~
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APPLICANT
INFORMATION:
.. TYPE of WORK: ".. _."'---RESIDENTIAL:.. _...~
. -GOMMEROAL:
PROPERTY
OWNER
INFORMATION:
PHONE:
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City
State
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City
State
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INSPECTION
INFORMATION:
DATE OF INSPECITON:
TIME OF INSPECITON:
o UPGRADE SERVICE: From
to
,
MOVING SERVICE FROM OVERHEAD
TO UNDERGROUND?
~S DNO
TYPE OF IMPROVEMENT:
o UPGRADE PANEL BOARD(S)
Number of NEW CIRCUITS:
o ADDmON, ALTERATION, REMODEL, or REPAIR TO
AN EXISTING ELECTRICAL DISTRIBUION SYSTEM
Number of METERS:
o NEW METER SERVICE (i.e. Fountain in pond;
Subdivision street or signage lighting; Installation of
new utility services for an area)
,
ONTAIN ED
CURATE!
,
o ROW SIGNAL, SENSOR, MONITOR (i.e. Traffic Light)
o CONNECITON or RECONNECITON TO A RELOCATED
STRUCTURE
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PIliNT DATE
COMMENTS or FURTHER LOCATION CLARIFICATION:
(Please attach maD of insDection location)
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FEES: $ 100.00 for Commercial Inspections; $ 55.50 for Residential Insped;ions
S:Permlts/FormsjElectrical Application Apr 2006