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Home My WebLink AboutElectrical Permit 12.0101 ..` 4YNES°1 r l CONTRACTOR /REGISTERED EMPLOYER REQUEST FOR ELECTRICAL INSPECTION Date Rough -In Inspection Required? s Inspection Other Than Rough -in: Q Ready Now /), / Contractor /Employer Must Schedule All Rough -In Inspecti ns Contractor /Employer Must Schedule All Final Inspections (/ Q hedule Addres tit sVrirs treet C - Project Description: I, ,$),44 Owner Nam i � / C )sr- v 1,c,f - o 1 / `.�„ Owner Phone ) , e / ie . V� 1 Home: Cell: ° i Contr ctor /Registered Employer N me Contractor Registered Employer Mailing Addres 0 1 C itC / . T Contractor /Employer Telephone Number Contractor/Employer E-mail Address Electrical Utility Wor . S2 /j : mb Q 41/it 1/iULil 4.3 / � ( 1 V� , t0J'1. C ntractoP "miyer Authorized Signature Contractor License Numb Job /Project Contact Person: -..,, i,i%/..____...____---- OM 1 q FEE CALCUL TION 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 a..1 to electric si:n and outline li:htin: _ Transformers Up to 10 kva ( ) @ $15 Each ( ) New Multi - Family Dwellings @ $70 Each ( ) 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 number of r quired inspection trips, whichever is greater) 75 C r� .) S Z Re4 6 ri 5 S(" 44 4/2 Receipt # Ca-G J ) (0 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 Order for Payment Date Request for Inspection Serial Number Date Filed /2.--0/0( 3 —Z/ -/2 Electrical Contractor /Installer License Number A5 ELEErR Owner /Occupant County F4/1/T,4 CONsr�vo - ro/V S c—o Job Address - Street it ownns fo , 9 / I'VE ' fi, 0/e 44K am" This Order for Payment is for additional fees associated with the above referenced Request for Electrical Inspection. Fee Calculation /Explanation oa 200A.0 , 35=- ePee-AirrS 04.7$044D Kul 12, 1-1 f Z eZCONNLC- Cee-0/7- e 200 - Z4l. oa 11373 91,-- " s ( 07 de 144boour PAIL' -7d d ,At,AYUPu g437-, Return this Order for Payment with your check payable to theali in the -� v amount of $ / a29 by (fourteen days from the date issued) A service charge of S30 wit be added for all dishonored checks. Inspector Name and Number For Department Use Only CJ/467 1_1,45/19 umb /1/ Inspector Telephone Number �a (/ As 9 22 2/ I 4/\ nspector E -mail AddressfWebsite Inspector na re P �� `J( � - --- OP-Mu 617 144,7t-f l ( (S7r S 5 . (2 to G4- -op-6a r �, 35 /:_5-70.-r (0 7 P R I O R LAKE BUILDING AND INSPECTION INSPECTION R ECO R D SITE ADDRESS NATURE OF WORK USE OF BUILDING PERMIT NO. DATE ISSUED CONTRACTOR PHONE NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR DATE FOOTING 1 FOUNDATION (Prior to Backfill) PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS SEWER / WATER / SEPTIC FRAMING INSULATION ELECTRICAL PLUMBING HEATING (if required) FIREPLACE GAS LINE AIR TEST COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I - FINALS GRADING (Prior to Sodding) BUILDING ELECTRICAL PLUMBING HEATING DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED NOTICE This card must be posted near an electrical service cabinet prior to rough -in inspections and maintained until all inspections have been approved. On buildings and additions where no service cabinet is available, card shall be placed near main entrance. FOR ALL INSPECTIONS (952) 447 -9850