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HomeMy WebLinkAboutElectrical Permit 12. 052 Ma ► L Chia/ of Prier La k_.e_ 174ly Dakbtc (tro-f* S. E • - --- P elOr L ab , I V `N\ SS 3 la For Office Use Only Amount of Check: Check # PermitTRAK # 5 fINNES TADEPARTMENT O -, �"'. - � J ELE /Z ' 0 L LABOR INDUSTRY iii, • • : afayette - - - d North Request for Electrical Inspection (REI) St. Pau , .4.. 5155 -4342 Pho -. 65 •:4 -5026 Non - Dwellings and Multi - Family Dwellings wwliw.dli.mn.gov Fields marked with an asterisk * are required (as applicable). * TODAY'S DATE Incomplete, inaccurate, or illegible forms may be returned to the submitter. * Check One: p Contractor or ❑ Registered Employer * Check One Box: ❑ New Bldg or ❑ Existing Bldg * Check One Box: ❑ Multi - Family Dwelling or ❑ Non - Dwelling (all projects other than dwellings) * Permit Sub -Type (check one box) ❑ Agricultural ❑ Commercial ❑ Government ❑ Industrial ❑ Institutional ❑ Recreational ❑ Technology * Project Location (number & street name) * Project County 15860 FISH POINT SE Scott * Project Township: (Please enter only the township name * Project City: * Project Zip or the city name, not both) PRIOR LAKE 55372 * Owner Name * Owner Phone Owner Cell Owner E -mail TWIN OAKS MIDDLE SCHOilI * Company Type (check one box) El Electrical Contractor ❑ Technology System Contractor ❑ Registered Employer ❑ Class B Installer * Company License /Registration No. * Company Name TS00686 Nardini Fire Equipment Co., Inc. * Company Address * City * State * Zip Code 405 County Road E West Saint Paul MN 55126 * Company Phone Company Cell * Company E -mail Contact Person and Phone Number 651.483.6631 612.919.2480 agerboth @nardinifire.com AMANDA GERBOTH 651.287.1074 * Project Description (Scope of work, service size, quantity of *Single Inspection *Rough in Inspection feeders and circuits, job numbers, or other vital information to Other than Rough -in? Required? help the electrical inspector make timely inspection service) ❑ Ready Now or ❑ Yes or © No © Will Schedule Directions to Project Site INSTALLATION OF TWO (2) CLEAN AGENT FIRE — SUPPRESSION SYSTEMS IN TWO SERVER ROOMS. Project Site (Contact Person and Phone) Electrical Utility TOTAL INSPECTION FEE from REI fee worksheet, or $35 multiplied Enter Inspection Fee Here» * $35.00 by the number of required inspection trips, whichever is greater. A surcharge of $5 is imposed on every permit effective 7/1/10 Surcharg e Fee » $ 5.00 as per M.S. § 326B.148, in addition to the inspection fee. * * Grand Total (Inspection Fee plus Surcharge Fee) $40.00 Requests for Electrical Inspection (REI) with a fee of $250 or less expire 12 months from the filing date. The installer 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 an expired REI to a new REI. A service charge of $30 will be added for all dishonored checks. This material can be made available in different forms, such as large print, Braille or on a tape. To request, call 1- 800 - 342 -5354 (DIAL -DLI) Voice or TDD (651) 297 -4198. REI 11 (3/11) REI_ 11 _MultiFamilyAndNonDwellings.doc (Revised 3/1/11) I