HomeMy WebLinkAboutElectrical Permit 12. 0017 o� 81°) PERMIT # 12- d/
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44NMES0" HOMEOWNER REQUEST FOR ELECTRICAL INSPECTION
1 Yes Inspection Other Than Rough -in:
® Ready Now
1/10/2012 0/2012 Hommeoweow
1a Ho T Required? Homeowner Must Schedule All Final Inspections I Will Schedule
neer r M Must S ust Schedule All Rough -In Inspections Description:
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Address of Inspection - Street P roect D sc of wiring already in place as part of the original new
Own Steve
Owner r N a m ndra Street SE, Prior Lake, MN 55372 construction in 1994. Adding a combination ceiling Tight /vent fan, e Own and Heidi increasing the number of Tight switches at door location (single to a
Owner r Ph Heidi Pflipsen triple), adding (1) GFI outlet next to sink, and adding (1) Tight over the
Home: Ph 952 -447 -0614 232
H eone Cell: 612-490-6232 sink.
Electrical Utility
Owner Mailing Address (if different from above) Basement bathroom
Same
By signing this document, I certify that I am the owner as defined by Minn. Stat,325.01 and will legally perform the electrical work.
Owner Signature
/ FEE CALCULATION
New Home or Associated Structure i 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 Service /Power Supply 401 -800 ampere @ $60
New Home Service 401- 800 ampere @ $60
t o 30 Feeders/circuits New /Extended Feeders /Circuits Up to 15 Feeders /Circuits ()
Up t
New Home Feeders/Circuits $1 . Feeders /Circuits @ $6 Each or 16 to 30
derrs s//cici rccuits $100
New Extended Feeders /Circuits - More than 30 Feeders/
New Home - Mor than 30 Feeders/Circuits (in addition to above . Circuits ( ) Feeders /Circuits Up to 200 A @ $6 Each
OFeeders /Circmts up to o 200A @ $6 Each
Other (Specify)
Reconnected Feeders /Circuits () @ $2 Each
$35 Each Special Inspection Fee ( ) Hours @ $80 Per Hour
Manufactured Home Park Lot Supply ( ) Plus Miles @ The IRS Milea :e 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
Reconnected Feeders /Circuits ( ) @ $2 Each
Other (Specify) MI
- State Surcharge = $5.00 5 UQ
Other (Specify)
-
TOTAL (the o f fee calculated above or s, whichever multiplied by the TOTAL (the fee calculated above or $35 multiplied by the
_ _ -_- _ -_ --
number of re � aired ins � ection ties, � s, whichever is : tea er
number of re aired ins section tri • s, whichever is : reater Receipt # 4 4/ of U
Requests for Electrical Inspection (REI) with a fee erlsubmitanother REI that includes nspection fee for
m have the work completed within the 12 month period or
the uncompleted work. Inspection fees do not carry over ho noted checks.
A service charge of $28 will be
added for all dis
I hereby certify that I inspected the electrical installation herein on the
dates stated: Walt Lusian, Electrical Inspector
Rough In Inspection (s) Date 952.934.0229
Final Inspection Date