HomeMy WebLinkAboutElectrical Permit 12. 161 t
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ES° f CONTRACTOR/ REGISTERED EMPLOYER REQUEST FOR
ELECTRICAL INSPECTION s60,50 120 30 \
Date Rough- In Inspection Required ? Z5Yes Inspection Other Than Rough-in : Q Ready Now
r � 1f) �� O / Contractor/Employer Must Schedule All Rough-In Inspections Contractor/Employer Must Schedule All Final Inspections
" J ` C/ ill Schedule
Addre f $pgction - t Project Description : n n lL 1 L l C N �.
Owner N e j A
Owner Phone V � yc �1
Home : Cell :
Contractor/Registered Employer Name Contractor/Registered Employer Mailing Address
Contractor/Empri/ory\erTeleph �one Number Contra ct'oor/Empl/o�ye/r E-mail A
ddressElectrical Utility
Wor ( j�ij fl r\ � l Q I I l v1 oCo ractJJor/E UpllVer Authorized Signature Contractor License Nu berJob/Project Contact Person :
- M
FEE CALC
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 ( ) @$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 I
( ) Circuits Originating in the Equipment @ $ 6 Each Other 1 1 ( 11y " JAJW Ck*r
Street, Parking Lot, Lighting Standard ( ] @ $5 Each Over 600 Volts - Add the combined servicei/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
Triumber of required inspection trips, whichever is greateo
Receipt # t
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 Z 3 1
Date Request for Inspection Serial Number Date Filed
Electrical Contractorlinstaller / hip ZWC* i' License Number
Ict ks Pe Al G � /orV VOL I/ OeE 0 0 0 r 9 zl
Owner/Occupant County
Job Address - Street Ci ownship
2 0 /A/%E P/�►s5 �i21C�
This Order for Payment is for additional fees associated with the above referenced Request for Electrical Inspection ,
Fee Cal culation/Explanatio
wale
•
Return this Order for P ment with your check payable to the in the
amount of $ by (fourteen days from the date issued)
A service charge of S30 will be added for all dishonored checks.
Inspector ame and Number
) �^ A For Department Use Only
L ZZ)45// / �'/ -
Inspector Telephone Number
4 Y OZ2
Inspector E-mail Address/Website
Inspect r S' ature — —