HomeMy WebLinkAboutElectrical Permit 12. 0004 4 "°4 l "' / / / /J` L
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41 /NNEsel CONTRACTOR /REGISTERED EMPLOYER REQUEST FOR
ELECTRICAL INSPECTION
Rough -in Inspection Required? es Inspection Other Than Rough -in:
0 Ready Now
' Date Contractor /Employer Must Schedule AU Final Inspections
' , ( Contractor /Employer Must Schedule All Rough -In Insp ions Bill Schedule
y ` [ � 1 Project Description: %
Ad ess o s�ecti' i A4V t V1 , / . CSI
Owner Ph ne
Ow N rp�, _ I Ca1 ' I/J i it V I
1 V1 ` f ' A ' �_,
Home: Cell:
Contractor /Regi�ered Employer ailddress
Contractor /Registered plover Name VA S 2 1 ■
Electrical Utility
Contractor /Employer E -mail Address � ���
Contracto • /Employer Telephone Numb r •
Woli MO .,, V&...e i Cont ctor /Emp er uthorized Signature
Contractor License N ber Job /Project Contact Person:
eiro0o‘G
FEE C LCULATION
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
Equipotential Planes ( ) @ $35 Each
Center Pivot Irrigation Booms ( ) @ $35 Each
Service /Power Supply Above 800 ampere @ $100 Plus ( ) Electrical Drive Units @ $5 Each
New /Extended Feeders /Circuits Up to 200 A ( ) @$6 Each
Luminaire Retrofit Modifications ( ) @ $.2 Each
Feeders Circuits Above 200A ( ) @ $15 Each Concrete- Encased Electrode Inspection ( ) @ $35 Each
Feeders/
Investigative Fee $70 Or The Total Inspection Fee,
Reconnected Feeders /Circuits ( ) @ $2 Each 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 Other
( ) Circuits Originating in the Equipment @ $6 Each
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)
( ) New Multi- Family Dwellings @ $70 Each
Transformers Up to 10 kva ( ) @ $15 Each ( ) State Surcharge of $5.00
( ) Additional Circuits Above the 20 Allowed
Per unit @ $6 Each /1
TOTAL (the fee calculated above or $35 multiplied by the i (/lv V ,
Transformers Over 10 kva ( ) @ $30 Each number of required inspection trips, whichever is greater)
I Receipt# ( I
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 car period rh A se charge o $28 will be
the uncompleted work. Inspection fees do carry over from one REI to anothe
added for all dishonored checks.
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