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HomeMy WebLinkAboutElectrical Permit 12. 0099 X)IL / .7 131 rl :. " V to g 't��NnsEsotr © �� � Ll��l � � ® / � � ' G ST RE D FI PLO � ' R llOE l� �-' ST 1 0 �O ELEC TR (CAL UP , � �! SON Date TRogh-In Inspection Required? Q Yes Inspection Other Than Rough in : Ready Now tractor/Employer Must Schedule All Rough-In Inspections Contractor/Employer Must Schedule All Final Inspections Q Will Schedule Address of Inspection — C Stree / Project Description : r . : �. '(c{ � �' . Owner e Owner h ne // Home :e �Z. � "S � ! y p3 1 Cell : Contractor/Registered Eryiployer Name Contractor/Registered Employer Mailing Address* I AI� 3 Cam► b ;o . s �. f � Contrac r/Employer Telephone Number Contractor/Employer E-mail Address / Electrical Utility W r : n 7 we S& 115 Cell : 7, 7A2 .,LbSIrb ® �'� S l . co A-, C Ira�ctor/Employer Authorized Si nature Contractor Lic nse Number Job/Project Contact Person : FEE CALCULA T 0111 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 E ui otential 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 [S @$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 Milea a 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 ( ) 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 required inspection trips, whichever is greater) Receipt # ? 3 Q 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 U HOMEOWNER REQUEST FOR ELECTRICAL INSPECTION Dat Rough- In Inspection Required ? Yes Inspection Other Than Rough-in : O Ready Now ��► Homeowner Must Schedule All Rough- In Inspections Homeowner Must Schedule All Final Inspections Q Will Schedule A Addre of Infbecdon�Gn Street I �Ll ,1et � % � � Project Description : Prior Owner ame x avn► , IcA L ca5 Lo%om L ew 4s:4. F( pits #* �[ Owner Phone -1 1 � Home [P - �t3, Cell : 1d - agSS %7; 3 Owner Mailing Address (if different from above) Electrical Utility By signing this document, I certify that I am the owner as defined by Minn. Stat. 325 .01 and will legally perform the elec ical work. 0 e Sign atule AAA J ( g FEE CALCULATION New Home or Associated Structure Existing Home/Structure Remodel or Addition New Home Service/Power Supply 0 -400 ampere @ $35 New Home Service/Power Supply 0 -400 ampere @$ 35 New Home Service 401 - 800 ampere @ $ 60 New Service/Power Supply 401 - 800 ampere @ $ 60 New Home Feeders/ Circuits New/Extended Feeders/Circuits Up to 15 Feeders /Circuits ( ) Up to 30 Feeders/circuits $ 100 Feeders/Circuits @ $ 6 Each or 16 to 30 New Home - More than 30 Feeders/Circuits (in addition to above New/Extended Feeders/Circuits - More than 30 Feeders/ ( ) Feeders/Circuits up to 200A @ $ 6 Each Circuits ( ) Feeders/Circuits Up to 200 A @ $6 Each Other (Specify) Reconnected Feeders/Circuits ( ) @ $2 Each Manufactured Home Park Lot Supply [ ) $35 Each Special Inspection Fee ( ) Hours @ $80 Per Hour Plus Miles @ The IRS Mileage Rate of Detached Garage or Other Associated Structure Detached Garage or Other Associated Structure New Home Service/Power Supply 0-400 ampere @$ 35 New Home Service/Power Supply 0 -400 ampere @ $35 New Feeders/Circuits ( ) @ $6 Each New/Extended Feeders/Circuits ( ) @ $ 6 Each Other (Specify) Reconnected Feeders/Circuits ( ) @ $ 2 Each Other (Specify) State Surcharge = $ 5 . 00 '~ TOTAL (the fee calculated above or $35 multiplied by the TOTAL (the fee calculated above or $35 multiplied by the number of required inspection trips, whichever is greater) number of required inspection trips, whichever is greater) Receipt # (05 303 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