HomeMy WebLinkAboutElectrical Permit 12.460 f pRtp� E 7 :!- /2- ' V
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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 All Final Inspections
✓ Contractor /Employer Must Schedule All Rough -In Inspections ►_- ill Schedule
1 Project Description:
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Owner Name , 11 14 ,................
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Owner Phone ( W � . Cell I
Home: Mailing Address r aitki
Contractor /Registered Employer Name Contractor /Registered Employer M W6-1 4[
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Contractor /Employer Telephone ontractor /Employer E -mail Address
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e Number (�
Worlcr Z��C(� I qi not /en / c tt G t (t'
J Contra or Licen /see Nu�/�ber Job /Project Contact Person:
C. ractor /E• pl. 'Authorized Signature li l 1
",'`' 1 FEE CALC LATION
0 -400 am ere @ $35 Technology Systems Devices ( ) @ $ .75 Each
Service /Power Supply P
@ $60 Separate Bonding Inspections for Swimming Pools and
Service /Power Supply 401- 800 ampere 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
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
( ) Circuits Originating in the Equipment @ $6 Each Other
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
__ a ..1 to electric si: and outline li: 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 I AM al
number of required inspection trips, whichever is greater)
1 Receipt # 4 7 7O �/
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 fe do month t carry per from one submit another
to another. A includes the
charge of $28 will be
the uncompleted work. Inspection 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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