HomeMy WebLinkAboutElectrical Permit 11.0073 , 10 PERMIT# 11- 0073 I „p
'4tINNtsa� ' CONTRACTOR REGISTERED EMPLOYER R RE QU S FOR
ELECTRICAL INSPECTION
Date Rough -In Inspection Required? f\ t , I] Yes Inspection Other Than Rough -in: 0 Ready Now
f Contractor /Employer Must Schedule All Rough -In Inspect Contractor /Employer Must Schedule All Final Insp cti s
/ V(/ill Schedule
Address of Inspectio i. $tr t Project Description:
1 , i /;rte /6, /iu .5
Owne Name jai Mal 2 at/ , N
Owner Phone AO eiP&i j4 40 00 t2' ( !1t 1
Home: CeII: �'
Contractor /Registered Employer Nam Con ractor /Registered Employ- Mailing Address
Cc.riti actorlimploy:9r Teieplion,: Number Cv,.t i ct,,,'Ecipk;,ya: E ivail Addi Lsi ucctrici1 Utility
W -`
l,2 7 zi!f Ce �
Con or /Emplpv Signature
thoriizzed Si Contractor License Number Job /Project Contact Person:
7 7j4F 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 +9 . 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
appiy to electric sign and outline lighting)
Transformers Up to 10 kva ( ) @ $15 Each ( ) New Multi- Family Dwellings @ $70 Each
(k) State Surcharge of $5.00 5 '.
(' ' ) 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)
Requests for Electrical Inspection (REI) with a fee of $250 or less expire 12 months from the filing date. Th owner7J
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
Order for Payment
Date Request tor Inspection Serial Number Date Filed
'1� Il / / - - c oi< �` 7 /
le iri.18 I Contractor /Installer License Number
E S L
Owner /Occupant County
) ` 5 - 11 / - 1 f/ 446 - 3 o J
Job Address - Street Cit wnship
/ C raed 7 V - /c ' 4/1"/F
This Order for Payment is for additional fees associated with the above referenced Request for Electrical Inspection.
Fee Calculation/Explanation
/j) °a 3 6 cLo
f 6 L 0o
d rA oo
ii i` ► )06
NIIMAM
Return this Order for Payment with your check payable to the in the
Gel
amount of $ .✓ by (fourteen days from the date issued)
A service charge of $30 will be added for at dishonored checks.
Inspec r Name an Number For Department Use Only
Inspector Telephone tuber
L
Inspector E -mail Address/Website
Inr Sigt to e
C AS rf. e l,M - Cis r , It) %,--∎, 1 1 1 • fo 3 `F-
D u
eze 1 ,,, t , acice 1/ 6yLce--14-
�-- S42- 7/4/44
5„eott-4,1‘ 4.„ ./.41 0,4,fr
(0 (( (goity-