HomeMy WebLinkAboutElectrical Permit 12. 349 •
. "?"" CONTRACTOR /REGISTERED EMPLOYER REQUEST FOR
ELECTRICAL INSPECTION
es Inspection Other Than Rough -in: 0 Ready Now
Date I Rough-In Inspection Required? "� � \
/� Contractor /Employer Must Schedule All Final Inspections
l ` Contractor/Employer Must Schedule All Rough-In InspectionslI Schedule
" \��\� I Project Description:
Address of Inspection - Street 19%42- /\ v t ►Q�^ t/� n •
Owner Name ,,J► , 1 U YWA �S1 n
Owner Phone Cell:
Home: Contractor /Registered Emplo er Mailing Address
Contractor/Registered Employer Name �- ` (' � _ / � , / Emplo � y C/, „[ /p !1 A. ,
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Contractor /Employer E -mail Address Electrical Utility
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Contractor /EmployerT(e�lephone Number ��� rn'n j� � n � ( ,(�-
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WorkriC2� C{.(� __►!l �ti cY I{/t/ IY 1(/Y et(S (E'/ItGII, sikrt
"!, JV Q 1j� Job /Project Contact Person:
C ractor /E pl r Authorized Signature Contra or License Nu er
� �- /�'� All i t
FEE CALL LATION
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
aire 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 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
apply to electric sign and outline lighting)
( ) 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 AA 1
number of required inspection trips, whichever is greater) 7V • V V
I Receipt # ( 10 ej I
Requests for Electrical Inspection (REI) with a fee of $250 or less expire 12 mo nths 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
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