HomeMy WebLinkAboutElectrical Permit 12. 462 / : 1 V. - - 11 `1 Lie).-
` ? "' CONTRACTOR /REGISTERED EMPLOYER REQUEST FOR
ELECTRICAL INSPECTION
Rough -In Inspection Required? ( es Inspection Other Than Rough -in:
Ready Now
,
Date Contractor /Employer Must Schedule All Final Inspections
^ Contractor/Employer Must Schedule All Rough In Inspections P-- ill Schedule
L Project Description:
Addr•s . ed • i � i • �
1.41 .. I i . 'rp VC s[ di/ �_
Ow % % e 4t --' V �/ V
Owner Phone Cell:
Home: Contractor /Registered Emplo er Mailing Address � � '
Contractor/Registered Emplo , �/1 \ r) � � l l/ Um �
• Q,Y1 C.iv,''v � � � (J Y O Electrical Utility
E -mail Address
ContradorJEmpl10 (y��erTelephone Number ((''��//�� ''/n� � � e�►
Wor C �� 49 d t Itri li k eie G -`
JJ Contra or License Nurrrrllber
C rador /E pl�er Auth Signature j Job /Project Contact Person:
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R,�.- C(>/ (_
�- �' " FEE CALC CATION
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 ( ) @ $.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
Special Inspection Fee ( ) Hours @ $80 Per Hour
Manufactured Home Park Lot Supply ( ) @ $35 Each 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 f
_ a • 61 to electric si: and outline 11: tin:
( ) 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
Transformers Over 10 kva ( ) @ $30 Each TOTAL (the fee calculated above or $35 multiplied by the j al
number of required inspection trips, whichever is greater) 7�
I Receint # 6 77€ ?f !� I
Requests for Electrical Inspection (REl) with a fee of $250 or less expire 12 months from the filing date. The owner
must have the work completed within
n fe do not carry over from one REI toanother�. Ae service charge of $28 for
8 will be
the uncompleted work. Inspects
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
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