HomeMy WebLinkAboutElectrical Permit 12. 197 a �.,iJ �•u U tin �,�-
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4, ` CONTRACTOR/REGISTERED EMPLOYER REQUEST FOR
ELECTRICAL INSPECTION
Date Rough -In Inspection Required? it/e/ Q Yes Inspection Other Than Rough -in: Q Ready Now
Contractor /Employer Must Schedule All Rough -In Inspections Contractor /Employer Must Schedule All Final Inspections •
1/ ` Schedule
Address of Inspection - Street e- Project Description:
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Owner e
Orli Owner Phon
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Cell: gy 7 9 9 3 cfsq 6
Contracto egistered Employer Name Contractor /Registered Employer Mailing Address
er s ,Pecf'%c ,Tvt_L. / 8Y 240 ij[te-fie
Contractor /Employer Telephone Number P / Contractor/Employer yer EE -mail Address Electrical Utility
Work: Cell. S/ 6665 /1 Cf e /tom �. Ccc.,,cc.,,-___ w . .-
Contra for /Emp oyerAu horriizzeed ! ignature Contractor License Number Job /Project Contact Person:
FEE CALCULATION
Service /P. wer 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 - �v Concrete - Encased Electrode Inspection ( ) @ $35 Each
1
Reconnected Feeders /Circuits j).7) @ $2 Each c(7 Investigative Fee $70 Or The Total Inspection Fee,
jf 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
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 calcul -t- • i bove or $35 multi .lied by the
co 90
number of re. uire - 1 , on tri. s, wh' - - er is • eater)
4 pJa 19920 or `7 0 g ' if, 11111 7 — ceint## ( 07z_
Requests for Electrical Inspection (REI) with a fee of $250 or less e • s ire ' months from the filing date. The owner
must have the work completed within the 12 month period or submit an . ther 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
/4-7 - (Z 952.934.0229
Final Inspection Date