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Electrical Permit 11.267
,o PRI 1U . nri LI °' CONTRACTOR /REGISTERED EMPLOYER REQUEST FOR ELECTRICAL INSPECTION Datp Rough -In Inspection Required? © Yes Inspection Other Than Rough -in: Ready No) 11 Contractor /Employer Must Schedule All Rough -In Inspections Contractor /Employer Must Schedule All Final Inspe�c ions �� 11 © Will Schedule Address of Inspection -Street 570 , / e'4 e /l /_ i Project Description: fat& /t Owner Name Le li /4, ks }Cce I e r5 y l Owner P e , 30 �1�/ Home: S2 .2!0!' Cell: Contractor /Registered Employer Name Contractor /Registered Employer Mailing Address V NT ELEc. lc. CoRPogirrioN1 23o0 Terri *Nat 1 goad, TI . Pay 1 MN stvi • Contractor /Empl�o Number Contractor /Employer E -mail Address Electrical Utility �J! Work:0s' ./14)1V a7�?at�'� ikife /tC � )(ceI GNQrgy Cont r /EmplloyerAuthorized Signature Contractor License Number Job /Project Contact Person: EP x Sg 3 Anti 47i M 4k- FEE CALCULATION Service /Power Supply 0 -400 ampere @ $35 Technology Systems Devices ( ) @ $ .75 Each • Service /Power Supply 401- 800 ampere @ $60 Separate Bonding Inspections for Swimming Pools and Equipotential Planes ( ) @ $35 Each Service /Power Supply Above 800 ampere @ $100 Center Pivot Irrigation Booms ( ) @ $35 Each Plus ( ) Electrical Drive Units @ $5 Each New /Extended Feeders /Circuits Up to 200 A ( ) @$6 Each Luminaire Retrofit Modifications ( ) @ $.25 Each Feeders /Circuits Above 200A ( ) @ $15 Each Concrete - Encased Electrode Inspection ( ) @ $35 Each Reconnected Feeders /Circuits ( ) @ $2 Each Investigative Fee $70 Or The Total Inspection Fee, Whichever is Greater Up to $1,000 Manufactured Home Park Lot Supply ( ) @ $35 Each Special Inspection Fee ( ) Hours @ $80 Per Hour Plus ( ) Miles @ The IRS Mileage Rate of ( ) Recreational Vehicle Site Supply Equipment ( ) Circuits Originating in the Equipment @ $6 Each Other Street, Parking Lot, Lighting Standard ( ) @ $5 Each Over 600 Volts - Add the combined service /power supply and feeder /circuit fee to result in double the regular fee (does not apply to electric sign and outline lighting) Transformers Up to 10 kva ( ) @ $15 Each ( ) New Multi- Family Dwellings @ $70 Each (001 State Surcharge of $5.00 ( ) Additional Circuits Above the 20 Allowed Per unit @ $6 Each Transformers Over 10 kva ( ) @ $30 Each TOTAL (the fee calculated above or $35 multiplied by the 44. OO number of required inspection trips, whichever is greater) Receipt # 64183 Requests for Electrical Inspection (REI) with a fee of $250 or less expire 12 months from the filing date. The owner must have the work completed within the 12 month period or submit another REI that includes the inspection fee for the uncompleted work. Inspection fees do not carry over from one REI to another. A service charge of $28 will be added for all dishonored checks. I hereby certify that I inspected the electrical installation herein on the dates stated: Rough -In Inspection (s) Date Walt Lusian, Electrical Inspector 952.934.0229 Final Inspection Date N 011‘4.1441141