Loading...
HomeMy WebLinkAboutElectrical Permit 11.0033 tfr,/e _. �S `- J '3k/ Fer. , e I 1 W e i r 1 1 ° CONTRACTOR /REGISTERED EMPLOYER REQUEST FOR ELECTRICAL INSPECTION Date Rough -In Inspection Required? Yes Inspection Other Than Rough in: Q Ready Now q / M Contractor /Employer Must Schedule All Rough In spedtippons Contractor /Employer Must Schedule All Final Inspections DU • D 3 f / ')SLWill Schedule Address of Insp tion -Street ' \\ / Project Description: pi SpEC f Ex I ST /W &- efriNE1- L Le Sir �c -e \�&� dl //v ,'Eer 04,NE,+z w/2/AIL - -».s4 Owne me y L, ^ C/ /2 cL ra f ov ton -Act , 2 c FE v Owner Phone C / 2 G v/ TS Home: lv /14 Cell: (p11 -y 3 2 - n - 7 Contractor /Registered Employer Name Contractor /Registered Employer Mailing Address /M/( FA s T6 a-- LLc u— (-- S 3 42, 3 A 5 ` c45 e AAA.; Contractor /Employer Telephone Number Contractor /Employer E-mail Address Electrical Utilit y Work: Cell: 9 Q, $yt.'35S'S 9 . 45 /. 3'1,35 /I'latf - 0 Mast - e..c it. ctrlL. cv X CC- Contractor /Employer Authorized Signature Contractor License Number lob /Project Contact Person: 1 Wc / , ll 9 — Alt Ct ft P/iz.ic-t.-_ 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 3 f' _ Luminaire Retrofit Modifications ( ) @ $.25 Each Feeders /Circuits Above 200A ( ) @ $15 Each � W -• " ` tI* ? CWU-6' - 35 Reconnected Feeders /Circuits (tb) @ $2 Each tO 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 1 -.1.. a � V �---" Street, Parking Lot, Lighting Standard ( ) @ $5 Each Over 600 Vohs- 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 ( ) Additional Circuits Above the 20 Mowed Per unit @ $6 Each Transformers Over 10 kva ( ) @ $30 Each TOTAL (the fee ca Wated- abetr35_multiplied by the number of req red inspection trips, w " ever is greater) Requests for Electrical Inspection (REI) with a fee of $250 or less expire om 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 ( 31 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 Order for Payment Date Request for Inspection Serial Number Date Filed /1 -3-- /l // --0o33 I-- -// Electrical Contractor /Installer license Number Owner /Occupant County 1a2f1 L/112 S c n Job Address - Street Ci ownship 278( ZS'f'fliN /.,rkE /3; 4. LAK This Order for Payment is for additional fees associated with the above referenced Request for Electrical Inspection. Fee Calculatio /Explanation ©� ` /N`P C,r76 F (° -N,i L, 3. Return this Order for Payment with your check payable to theallIMIIIMIMISMIBUIMINNie in the amount of $ by (fourteen days from the date issued) A service charge of $30 will be added for all dishonored checks. Insp cto ame and Nyumber For Department Use Only G 7 / C7,544 Inspector Telephone Number Inspector E -mail Address/Website Inspe or S' natur • L loll/ �� *Tr A- KG / fe)