HomeMy WebLinkAboutElectrical Permit 12. 315 �j�
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PERMIT # 1.2- U
'4 "NN .--(1' CONTRACTOR /REGISTERED EMPLOYER REQUEST FOR
ELECTRICAL INSPECTION
Date
Rough -In Inspection Required?
r , 1
0 Yes Inspection Other Than Rough -in:
1 ; Contractor /Employer Must Schedule All Rough -In Inspections Re ady Now
. t f i 1 € Contractor /Employer Must Schedule All Final Insp l ions
i �.:
Address of Inspection - Street Q Will Schedule
C Project Description;
0 Owner Name
Gtr 11 >' •
Owner Phone
Home:
Contractor /Registered E I o'er r € • �. `--(---
Contractor /`egistered Employer Mailing Address
182 iiP,: :ST BROADWAY
`TA a 42•
Contractor /Employer Telephone N r
Work: / r 3 - 535 -2Q0 1 Contractor /Employer E -mail Address
Cell:
Contractor /Employer Authorized Signature
Contractor License Number Job /Project Contact Person:
FEE CALCULATION
Service /Power Supply 0 -400 ampere @ $35
Service /power Supply 401 - 800 ampere @ $60
IIIII
- Technology Systems Devices ( ) @ $ .75 Each
- Separate Bonding Inspections for Swimming Pools and
MI
Service /Power Supply Above 800 ampere @ $100 E. ui. otential Planes @ $35 Each
P lus Pivot t ri c i a D r Booms ( ) @ $35 Each
New /Extended Feeders /Circuits Up to 200 A Plus Electrical Drve Units @ $5 Each
( ) @$6 Each - Luminaire Retrofit Modifications
( ) @ $.25 Each
Feeders /Circuits Above 200A ( ) @ $15 Each
Concrete Encased Electrode Inspection ( ) @ $35 Each
Reconnected Feeders /Circuits ( ) @ $2 Each
W t i s Fee $er U r to $ $1, T000 Inspection Fee,
Manufactured Home Park Lot Supply Whichever s Greater U. to $1,000
PP y ( ) @ $35 Each Special Inspection Fee
( ) Hours @ $80 Per Hour
Recreational Vehicle Site Supply Equipment
Plus Miles @ The IRS Milea;e Rate of
PPY I
( ) 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
Transformers Up to 10 kva a..l to electric si' n and outline li;htin
( ) @ $15 Each ( ) New Multi - Family Dwellings @ $70 Each
( ) State Surcharge of
( ) Additional Circuits Above the 20 Allowed
Transformers Over 10 kva ( ) @ $30 Each Per unit @ $6 Each
TOTAL (the fee calculated above or $35 multiplied by the
number of re. uired inspection tri es, whichever is ; eater 11111M11
I Receipt # 42 9,5 1
Requests for Electrical Inspection (REI) with a fee of $250 or less expire 12 months from the fi
must have the work completed within the 12 month period or submit another REI that inc ud s inspection ti n 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 Inspetor
Final Inspection Date 952.934.0229