HomeMy WebLinkAbout07050019 Application
City of Carmel/ Clay Township
APPLICATION FOR ELECTRICAL INSPECTIO~
, D5'tJC1/t I
NAME PHONE FAX
CONTRACTOR c:.-re.o Co k\JcnON
INFORMATION: Street Address City State
~33 N.. 1'e.N~ Ivp..N\p, ~O'l'AN.t\: oHs ~ .J.f~
NAME CONTACT PHONE:
tJS "1 Co oS
sJ~ /07 I
I' DATE I
I
COMMENTS orl ~URTHER LOCATION CLARIFICATION: (Please attach maD of insDection location)
~ A~~)
AeJ)EN 16 w rJ 1-k>M\? S
APPLICANT
INFORMATION: Property Owner
(or agent)
TYPE of WORK:
RESIDENTIAL:
PROPERTY OWNER NAME(S):
PROPERTY
OWNER
INFORMATION:
STREET ADDRESS:
INSPECTION
INFORMATION:
STREET ADDRESS (INSPEcnON LOCATION):
} 0 €. l:5h~ ~
DATE OF INSPECTION:
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
~;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)
o CONNECTION or RECONNECTION TO A RELOCATED
STRUCTURE
OR
COMMERCIAL: ...........-
PHONE:
City
State
I
Zip
City
~e1-
State
Zip
.nJ
b~g;)
TIME OF INSPECTION:
,
MOVING SERVICE FROM OVERHEAD
TO UNDERGROUND?
DYES
o NO
Number of NEW CIRCUITS:
Number of METERS:
I CERTIFY THAT THE INFORMATION CONTAINED
ON IS FOR S COMPLETE AND ACCURATE.
51 r
~~
FEES: $ 104.00 for Commercial Inspections; $ 57.50 for Residential Inspeq:ions
I
S:p'ermits/Forms/Electrlcal Application Apr 2007 I
.
MftfJ
/?:'
///
"
/
;/
/
/
/
/
,/
/-:/
~"
--1 C~.."!~
~"'SLc..>L
j
J
"'I
,,0
fDrl f)"t6-(~1 c.,
"^~-nc..~~
w> 10',
^/30C
7W15
~" f1,,'~,~
- I' ILD,-~,U\ll \
;;r (:0;-\'(/' 'f
::r w\\\ ~ po.. tJ~~...!-
~V-'i:.- cfue- ~ ~""\'" '
~~b~~ \ NO\:> DSf~
0&7 H-1/NOI-
,/
I
--: --. ,--- '-.
!
"_".J
,J"-l
~s;,l
~)ld9 lb
:::;J' I
_~ I
~,-i '\
'-- "
T
~-
I '
.)
~-
"
9", j'
::r--L '
..:::J }.
.-..l -- " \,~.
~::.)3Id9~'
~I L'
~ {',
::'1~._.h:i i
-:1--"-'---1 ;
--=J ;f.
:",Bldg ,:
-1 ('
'1,.:.1: '
,'i' F-'i-
d~
'1 --, I
i r~-
" ~--
:'..J . r:
: ~~Idg (",
\2 ~~.
):. S' l__....\=~
g,':_cm-~
5.. : I ~-
""0 ;,~ ,--
r- . ~Idg :i-= --
:,l '\;:"
;
,pond 2
&'
" ,.,
,
.- ~'.
....'
\,
\'
\
\
\.
\
\
_~6'!!~ridgeDeck
-.,
--"\ (
l{
,