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HomeMy WebLinkAboutElectrical Permit 11.085 (3a 50j p4 PRt0 1 PERMIT # 11- OOf35 ' N s °' ` CONTRACTOR /REGISTERED EMPLOYER REQUEST FOR ELECTRICAL INSPECTION Date Rough -In Inspection Required? Yes Inspection Other Than Rough -in: © Ready Now 61j --� 2 ( f Contractor /Employer Must Schedule All Rough -In Inspections Contractor /Employer Must Schedule All Final Inspections i dill Schedule Addre s 1 ection. -Stree Project Description: _ 3/ - &S Owner Name y�, , /� , _ _;] _ e �:, i i- f00 /y y�e ,� Owner Pho { `/I l� q � � * th 1' J O �/`1 r �-�- \ro i Home: �� . ?j -l�, (e06(J Cell: Contractor /Registered Employer Name Contractor /Registered Employer Mailing Address ae. t' &L vt -W Yt- i C? -tom c . 1 ' h 6 ( ice 5(L?Y : - • &: S Oa +� X71 Contractor /Employer Telephone Number Contractor /Employer E -mail Address Electrical Utility / &/.J 6 Work. Lt l I g 7 Cell: Contractor /Employer Authorized Signature Contractor License Number Job /Project Contact Person: d (MSid 'GAD 0 1-fno, � 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 2 1 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 -i 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 State Surcharge of $5.00 c s 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 number of required inspection trips, whichever is greater) Receipt # (pl/-/ 7 7 6 ,4,,' 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 I" D 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 certi2y that I inspected the electrical installation herein on the dates stated: Rough - In In pection (s) Date Walt Lusian, Electrical Inspector 952.934.0229 Final Inspection Date oraer Tor raymeru iiimeilio Date Request for Inspection Serial Number Date Filed 9 2 9— // i/ -- e70eS 9 z // Electrical Contractor /Installer License Number ELEC ii L 1//s/ON ( / 3 ICVN Owner /Occupant • County R YL,AND /04E5 LS cc' /7 Job Address - Street Ci ownship 70 PO /t t17` P $5 pif 6e. G V/ This Order for Payment is for additional fees associated with the above referenced Request for Electrical Inspection. Fee Calculation /Explanation � s°o, q y c_F6 VV /c g .�� 00 '� C7, 0C) I t %/r Tp & ice._. — o F lk.ovhll f 1 /1 35, — P IqL4 N c,:> U., 2 � AIIIMIIIIII 1 1 Return this Order for Payment with your check payable t� ■ e in the �/ 04 " amount of $ / by (fourteen days from the date issued) A service charge of S30 will be added for all dishonored checks. Insp�e for,Name and N mber For Department Use Only Zr 1t7 1.14,r1�/ Inspector Telephone Number 75 ^7 7 Inspector E -mail Address/Website Inspector ignature -, `0.-. _ _ _ _. _ ceo e tA y 4 --- 8 (.46.4). ( c.,otc,_- 1 1 eviAmc c ___ 4,,, 6(1-3 t( L . 0VI di)-mu q(3/( ------