HomeMy WebLinkAboutElectrical Permit 12. 365 w .
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id "NES °� CONTRACTOR /REGISTERED EMPLOYER REQUEST FOR
ELECTRICAL INSPECTION
Date Rough -In Inspection Required? dyes Inspection Other Than Rough -in: O Ready Now
CI .•a - ) .. Contractor /Employer Must Schedule All Rough -In Inspections Contractor /Employer Must Schedule All Final Inspections
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Address of Inspection — Street Project Description:
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Owner Name �L O ti� L--.0 `Yt �:
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Owner Phone
Home: Cell:
Contractor/
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egistered Employer Name Contractor /Registered Employer Mailing Address
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Contractor /Employer Telephone Number Contractor /Employer E -mail Address Electrical Utility
Work: i. 3',, Cell:
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Contractor /Emp er Authorized Signature Contractor License Number Job /Project Contact Person:
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FEE CALCULATION
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
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 ( ) @$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 n) Ei ) c '-'- E f C --
Street Parking Lot, Lighting Standard ( ) @ $5 Each Over 600 Volts — Add the combined service /power supply and 1 �
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 5
Per unit @ $6 Each
Transformers Over 10 kva ( ) @ $30 Each TOTAL (the fee calculated above or $35 multiplied by the 0 44 v
number of required inspection trips, whichever is greater) 1
Receipt # 6 7.45
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Requests for Electrical Inspection (REI) with a fee of $250 or less expire 12 months from the filing date. The owner 0 / 7�
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
ai d fora 1 dishon red checks. _
, ..,_. I hereby certify that I inspected the electrical installatio erein ., the
dates stated:
Rough -In Inspection (s) Date Walt Lusian, Electrical Inspector
952.934.0229
Final Inspection Date
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O* PRI%
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t 4646 Dakota Street SE
.y, Prior Lake, MN 55372
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INVOICE
Date: 12/12/12 Invoice # 12 -145
To: Picha Electric
503 6 Avenue
New Prague MN 56071
DESCRIPTION
Additional fees owed on electrical permit #12 -365
for work done at 1702 Belmont Avenue
INVOICE TOTAL $35.00
Payment Due Upon Receipt
101 -20208
Phone 952.447.9800 / Fax 952.447.4245 www.cityofpriorlake.com
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