HomeMy WebLinkAboutElectrical Permit 12. 382 VR tp z
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`NN' ' CONTRACTOR /REGISTERED EMPLOYER REQUEST FOR
ELECTRICAL INSPECTION
Date Rough -In Inspection Required? 0 Yes Inspection Other Than Rough -in: 0 Ready Now
10/2/12 Contractor /Employer Must Schedule All Rough -In Inspections Contractor /Employer Must Schedule All Final Inspections
Will Schedule
Address of Inspection — Street Project Description:
14800 Jeffers Pass NW
Owner Name Adding circuits
ISD #719
Owner Phone
Home: Cell:
Contractor /Registered Employer Name Contractor /Registered Employer Mailing Address
Inc. 10195 Inver Grove Trail
Total Construction & Equipment, Inver Grove Heights, MN 55076
Contractor /Employer Telephone Number Contractor /Employer E -mail Address Electrical Utility
Work: Cell:
651 -451 -1384 651 - 775 -0287 jjohnson @total — const.com Minnesota Valley Electric Coop.
Contractor /Employer Authorized Signature Contractor License Number Job /Project Contact Person:
0"\-ti1/4---' EA -01833 Jason Johnson
FEE CALCULATION
I Service /Power Supply 0 -400 ampere @ $35 Technology Systems Devices ( 4) @ $ .75 Each
$3.00
Service /Power Supply 401— 800 ampere @ $60 Separate Bonding Inspections for Swimming Pools and
Equipotential Planes ( ) @ $35 Each
Service /Power Supply Above 800 ampere @ $100 Center Pivot Irrigation Booms ( ) @ $35 Each
Plus ( ) Electrical Drive Units @ $5 Each
New /Extended Feeders /Circuits Up to 200 A (1 ) @$6 Each $6.00 Luminaire Retrofit Modifications ( ) @ $.25 Each
Feeders /Circuits Above 200A (2 ) @ $15 Each $30.00 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 @ Tlje RRSMileag Rat of ( )
Recreational Vehicle Site Supply Equipment � tW S l� j Z
( ) Circuits Originating in the Equipment @ $6 Each Other r ( `� ^^ ' '�I f,. —
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)
Transformers Up to 10 kva ( ) @ $15 Each ( ) New Multi - Family Dwellings @ $70 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
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//,, ¢ number of required inspection trips, whichever is greater) . (-- 0 $q
4, j2/'// - i . 66 �znC 47733
Receipt # 6 / �.L-d
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 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 Walt Lusian, Electrical Inspector
952.934.0229
Final Inspection Date
WALT L USIAN
IAEI Certified
Master Electrical Inspector PD-P
" MINNESOTA DEPARTMENT OF s
LABOR & INDUSTRY o
. 76275 Sheldon Ave
Eden prairie; MN 55344 Office Hours 7:00.8:30 a.m.
Tel. (952} 934-022 Mon. -Fri
Order for Payment
Date Request for Inspection Serial Number Date Fled
/ / :- Z ‘-/2- / z-- OM' 2_ . / " Z
Electrical Contractor/Installer ( 'License Number
70 7;f Z COA/S c t7 /v v 4C &Ul E,f ea 0/fs33
Owner /Occupant County
775,1> Q ° - 7/ / SGO
Job Address - Street _0/ Township
7'9d L.7-'F f..eS 4ss ` i�'r'Z� 69fe
This Order for Payment is for additional fees associated with the above referenced Request for Electrical Inspection.
Fee Calcuiat onIExptanation
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Return this Order for Payment with your check payable to theasimiliMmIllasjoilmOSIIIIIIIO in the
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amount of $ —5 Q by (fourteen days from the date issued)
A service charge of $30 will be added for all dishonored checks.
Inspector Name and Number For Department Use Only
Inspector Telephone Number
Inspector E -mail Address/Web e
Inspector Signature {-✓
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