HomeMy WebLinkAboutElectrical Permit 12. 390 Ali
9 `, CONTRACTOR /REGISTERED EMPLOYER REQUEST FOR
ELECTRICAL INSPECTION
Date Rough -In Inspection Required? • Yes inspection Other Than Rough -in: O Ready Now
1 ° - I t t 1 - Contractor /Employer Must Schedule All Rough -In Inspections Contractor /Employer Must Schedule All Final Inspections
• W1ii Schedule _
Address of inspection - Street q Project Description:
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Owner Name W� /new r
R 4j g_oirt I 1 a rmi s
Owner Phone /
Home: (D 6(ry Cell:
Contractor /Registered Employer Name Contractor /Registered Employer Mailing Address
Contractor /Employer Telephone Number Contractor /Employer E -mail Address Electrical Utility
Work: 1 3 S -St -thestn5Ono. ,r . coal ii') /lEC
Contractor /Employer Authorized Signature Contractor license Number Job /Project Contact Person:
a• - 1ni... . Ei9 0 /am. to 0- ?? I - 3qq1
FEE CALCULATION
Service/Power Supply 0-400 ampere @ $35 _33 Technology Systems Devices ( ) @ $ .75 Each
Service /Power Supply 401- 800 ampere @ $60 Separate Bonding Inspections for Swimming Pools and
Service/Power Supply Above 800 ampere @ $100 Center Pivot I Planes ( ) @ $35 Each
Irrigation rrigation Berms ( ) @ $35 Each
Plus ( ) Electrical Drive Units @ *5 Each
New/Eztended 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 ID $1,000
Manufactured Home Park Lot Supply ( ) @ *35 Each Special Inspection Fee ( ) Hours @ $80 Per Hour
Recreational Vehicle Site S upp I Plus ( ) Miles @ The IRS Mileage Rain of ( ) •
y Equipment
( ) Circuits Originating in the Equipment @ $6 Each Other /LAW w ry. yra),_ /CO
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
Transformers Up m 10 kva ( ) @ $15 Each apply to electric sign and outline lighting)
( ) New Multi-Family Dwellings @ $70 Each
D4SIate Surcharge of $5.00 S
( ) 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
number of required inspection trips, whichever is greater) NO,"
Receipt # 6 (p7
Requests for Electrical Inspection (REI) with a fee of $250 or less expire 12 months from the filing date. Th owner
must have the work completed within the 12 month period or submit another REI that includes the inspection fee for
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
dates stated:
Rough -In Inspection (s) Date WaltLusian, Electrical Inspector
952.934.0229
Final Inspection Date