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HomeMy WebLinkAboutElectrical Permit 12. 009 01 1°4 .2,,,,:.„-u-, `21- - 0 ___ •__. _ 4. f«vES?tr. CONTRACTOR/REGISTERED E REQUEST FOR O ELECTRICAL INSPECTION Ready Now Inspection Other Than Rough -in: 0 Will Schedule Rough -In Inspection Required? Yes Contractor /Employer Must Schedule All Final Inspections Date Must Schedule All Rough -In Inspections Contractor/Employ � �, � 1 � Project Description: .--- � Z � �j � L Lets S' � .�% G CC" �- " Address of Inspection -Street Project Nor J CL Owner N�jn 0 3 —us r �' /� !D / 2 - -73 0 5? 7 Mailing Address Owner Phone Cell: Contractor /Registered Employer ff� Home: Tess 5C-- istered Employer Name L L 1 To ✓ c Contractor /Reg' >� � e ,�� lG 4 7 N� L � Electrical Utility Contractor /Employer E -mail Address n C.-- Contractor /Employer Telephone Number / �� e / C M q € 6-nti1 /_c, �/ R Work: 7 7 - 5 �� ell: `la, -ZIP-70 / !� '�� Job /Project Contact Person: Signature Contractor License Number ^ j O y 1/47 6-0422°' Contract.,. horized Sig �� G � � s-5-2_ S ' (• FEE CALCULATION Ilin Technology Systems Devices ( ) @ $ .75 Each MI Service /Power Supply 0 -400 ampere @ $ Separate Bonding Inspecti @ $3 °5 Each ming Pools and 1 401- 800 ampere @ $60 E. ui• otential Planes @ $35 Each Service /Power Supply Center Pivot Irrigation Booms ( $ MI 1 Above 800 ampere @ $100 111111 Plus Electrical Drive Units @ $5 Each $35 Each Service/Power Supply ILrs11 Luminaire Retrofit Modifications ( ) MI New /Extended Feeders /Circuits Up to200A n $6 Each @$35Each Concrete - Encased Electrode Inspection ( MI @ $15 Each Inspection Fee, Feeders /Circuits Above 200A ( ) Investigative Fee $70 Or The Total Circuits ( ) @ $2 Each 11111 Whichever is Greater U to $I1,000@ $80 Per Hour Reconnected Feeders/ Special Inspection Fee ( ) MI @ $35 Each Plus Miles @ The IRS Hour e Rate t l �/ IJu/CLLl N U /�/ a Manufactured Home Park Lot Supply ( ) � �� Si N6,-1,C r= A' Equipment Other C vyp -lb 0 c r rci ' -1-5 > ( ) Circuits Vehicle ing in Supply i ment @ $6 Each 1 and ( ] Circuits Originating in the Equ p Over 600 Volts - Add the combined service /power Supp Street, Parking Lot, Lighting Standard ( ) @ $5 Each feeder /circuit fee to result in double the regular fee (does not . as •1 to electric cam' and Dwellings l @ $70 Each ( ) New Multi -Fam Y Transformers Up to 10 kva ( ) @ $15 Each ( State Surcharge of $5.00 ( ) Additional Circuits Above the 20 Allowed ral 11.111 Per unit @ $6 Each TOTAL (the fee calculated above or $35 ultiipli sa boater , Transformers Over 10 kva ( ) @ $30 Each number of re . u•red ins • ection trips, // _ Pi') -- 4 � I V' Receipt # � � 0 *r ire 12 months from the filing date. The owner inspection w e for Inspection (REI) with a fee o $250 or less expire Requests for Electrical Insp period or submit another REI that includes the must have the work completed within the do of carry p 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 Walt Lucian, Electrical Inspector dates stated: Date 952.934.0229 Rough -In Inspection (s) Final Inspection Date Order for Payment Date Request for Inspection Serial Number Date Filed " /2— lz -000 fz - // Electrical Contractor /installer License Number GINI� '2EcZ ? /C Owner /Occupant County Job Address - Street � L y t 3 I � Z b't�TT�Nz/fi' C'i� �`�" This Order for Payment is for additional fees associated with the above referenced Request for Electrical Inspection. Fee Calculation/Explanation ' rr /aN•9� Coec - rs' Cv �o (3`{ creeVers 72 Return this Order for Prent with your check payable to theal.10.1111111111 in the p amount of $ _ 2 by (fourteen days from the date issued) A service charge of S30 will be added for all dishonored checks. Inspecto Name and Number J For Department Use Only 7- 40S / 19A/ Inspector Telephone Number QSz_ zZ Inspector E -mail Address/Website Inspector Si ature Lt./ T 143 �� C. ©. 7A)7