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Home My WebLink About222852 08/13/2013 CITY OF CARMEL, INDIANA VENDOR: 00352481 Page 1 of 1 ONE CIVIC SQUARE BURTNER ELECTRIC&LIGHTING CARMEL, INDIANA 46032 787 N.10TH STREET CHECK AMOUNT: $351.50 '? NOBLESVILLE IN 46060 CHECK NUMBER: 222852 CHECK DATE: 8/13/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 101 5023990 64 . 00 OTHER EXPENSES 1120 4350100 44389 287 . 50 BUILDING REPAIRS & MA **CO,\ IPLETE & RETURN REFUND REQUEST THIS FORivI TO: U -AL Building &Code Services City of Carmel `*.;N°,"-„,,,,` ,;.” Ph. (317) 571-2444 Fax (317) 571-2499 Building &i Code Services = One Civic Square; Carmel, IN 46032 PERMIT #(s): �� 1 Lot & Subdivision, or Address of Construction: (If more than one address needs to be listed and will not fit, please attach a printed list of all permits, with their corresponding permit#.) Please print or type the reason for the requested refund, and specific fee or fees which area requested in the lines be ow: l l o 9 I ! TOTAL REFU`D VVIOUNT REQUESTED: CL/ . w EE ( n4 Applica n\t4ig nature AUG 0 8 2013 Date Applicant Name— Printed BY Company Name (If applicable) APPLICANT ADDRESS: --� 2-7 St r et Address city- _...._.... - - _. _.. .. - ST Phone # Fax # FOR OFFICE USE ONLY: p Total amount for fees that ARE available for refund: p Fees that are NOT available for refund: p Refund approved by: Date: I p Date submitted for Payment: Amount Approved: i REFUND REQUESTS MUST OCCUR WITHIN: RESIDENTIAL PERMITS: Within 180 days from the issuance date of the permit. COMMERCIAL/INSTITUTIONAL/MULTI-FAMILY: Within 1 year of the issue date of the State Commercial Design Release (CDR) **If there is NO CDR, they need to begin within 1 year of the issuance date of the permit. FEES WHICH MAY BE REFUNDED ARE: ® Inspection Fees. Count the number of inspections charged on an ILP application (assessed by plan review). 0 Certificate of Occupancy or Substantial Completion Fees. To be refunded. • PRIF Fee. To be refunded. • Fees (re-inspection, late fees, "other" inspection fees): Refunds can be made if it has been determined that a "clearly defined error" has been made when a re-inspection, late, and/or "other" fee has been assessed. NOTE: If an ILP has gone beyond 180 days for start of con,".4ruction, no refund can be generated because the ILP is technically invalid/expired If, however, the applicant has requested, and has been granted, an`extension of time prior to the 160 day dead line, a refund could still be granted, all under the terms as outlined above. _ = NOTE: Applicants requesting refunds for sewer and/or water permits should be directed to the utility provider. (Carmel Utilities or CTRWD.) i S:Permits/Forms/Refund Request Form CITY OF CARMEL ITEM 1 OF 1 PERMIT RECEIPT OPERATOR: plux COPY # 1 Sec : Twp: Rng: Sub: 194 Blk: Lot : 25 PARCEL ID . . . . . . . . : 1713020406018000 DATE ISSUED. . . . . . . : 08/02/2013 RECEIPT # . . . . . . . . . : BC000005967 REFERENCE ID # . . . : 13080017 SITE ADDRESS . . . . : 10909 PARK AVE SUBDIVISION . . . . . . : COLLEGE HEIGHTS CITY . . . . . INDIANAPOLIS IMPACT AREA OWNER . . . . . . . . . . . . : BLALOCK, JUDTIH ADDRESS . . . . . . . . . . : 10909 N PARK CITY/STATE/ZIP . . . : INDIANAPOLIS, IN 46280 RECEIVED FROM . . . . : BURNTER ELECTRIC CONTRACTOR . . . . . . . : BURTNER ELECTRIC ID-EBURTELE COMPANY . . . . . . . . . . : BURTNER ELECTRIC ADDRESS . . . . . . . . . . : 787 N 10TH ST CITY/STATE/ZIP . . . : NOBLESVILLE, IN 46062 TELEPHONE . . . . . . . . : (317) 773-7663 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- IRESELEMTR PER INSPECTIO 1 . 00 64 . 00 0 . 00 64 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 64 . 00 0 . 00 64 . 00 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 64 . 00 24742 --------------- TOTAL RECEIPT 64 . 00 t CQ Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995) CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee/ oevrf�E2 ZL Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Fa r7,J - iZ fCA c 17-Cl/An-1 kk ihs 41-11.' CP r�J I Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5-11-10-1.6. 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 190,e T��2 �� IN SUM OF $ ,7�� $ AZ/•OC7) ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#!TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 20 ign t ter` Title Cost distribution ledger classification if claim paid motor vehicle highway fund i INVOICE Burtner Electric Inc. INVOICE 44389 PAqE '1 1 Noblesville IN 46060 LEWT,�__ 07/24/2013 Phone: 317-773-7663 Fax: 317-776-3029 REFERENCE MIKEL TELEPHONE 590-3426 CELL CUSTOMER JOB NUMBER 34831 FORMAT UA ACCT 114349 2 CIVIC SQUARE SOLD BY —CARMEL IN AUTHORIZED BY JOB LOCATION JOB DESCRIPTION |— 5032 E. MAIN STREET DROP CORDS FOR TRUCKS NOT WORKING CARK8EL STATION 44 OUTLET IN BAY AREA NOT WORKING ALL PAGTOUEG ARE SUBJECT TOLIEN Material/Work Description Charge Material Total .00 Labor/Work Description Charge FOUND 2 LOOSE NEUTRALS IN ATTIC Labor Provided 287.50 Labor Tota 1 287.50 TOTAL$ 287.50 'rescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL \n invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by vhom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 44389 Sta. 44 $287.50 I I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Burtner Electric IN SUM OF $ 787 North 10th Street Noblesville, IN 46060 $287.50 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 I 44389 I 43-501.00 I $287.50 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except n I I122B Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund