HomeMy WebLinkAboutElectrical Permit 12. 304 IPR
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ELECTR (CAL 0\15PECT ON
Date Th-In Inspection Required? Xctionses Inspection Other Than Rough in : Q Ready Now
l t actor/Employer Must Schedule All Rough- In Ins Contractor/Employer Must Schedule All Final Inspectio s
t Will Schedule
Address of Inspgor 6rgl � Project D scriptlon :
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Owner Name
Owner Phone
Home: Z � � � 5 .* � V9 � Celle
Contractor/Registered ETployer Name Contractor/Registered Employer Mailing Address *
z.
ontract r EmployerTelephho(ne Number Contractor/Employer E-mail Address Electrical Utility
Contr to E ploy hodzed ' nature Contractor License Number Job/ roject Contact Person :
-�/`jj 6 o 6 Y 3 (0 3 � � 9
FATE 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
E ui otential 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
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 -0 $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 15 , 710
number of required inspection trips, whichever is greater) 7�►
Receipt # & & 9Z 0
Requests for Electrical Inspection (REI) with a fee of $2 50 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
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so' HOME ® �iII�� -0 ' ' !_ QU �-0 ll ® 1 E � (C `� �Z CAL � IgSP � C� ` 1 ON
Date Rough-In Inspection Required? O Yes Inspection Other Than Rough-in : O Ready Now
— .2 I — / Homeowner Must Schedule All Rough-In Inspections Homeowner Must Schedule All Final Inspections Q Will Schedule
Address of Inspection — Street Project Description :
C & JoLr S
Owner Name
� t i� o/J
r ht A 01 �—
Owner Phon
Home: q C2 8S' S Q Cell:
Owner Mailing Address (if different from above) Electrical Utility
By signing this document, I certify that I am the owner as defined by Minn. Stat. 325 .01 and will legally perform the electrical work.
Owner Signature
FEE CALCULATION
New Home or Associated Structure Existing Home/Structure Remodel or Addition
New Home Service/Power Supply 0400 ampere @ $35 New Home Service/Power Supply 0-400 ampere @$35
New Home Service 401 — 800 ampere @ $60 New Service/Power Supply 401 -800 ampere @ $60
New Home Feeders/Circuits New/Extended Feeders/Circuits Up to 15 Feeders /Circuits ( )
Up to 30 Feeders/circuits $ 100 Feeders/Circuits @ $6 Each or 16 to 30
New Home — More than 30 Feeders/Circuits (in addition to above New/Extended Feeders/Circuits — More than 30 Feeders/
( ) Feeders/Circuits up to 200A @ $6 Each Circuits ( ) Feeders/Circuits Up to 200 A @ $6 Each
Other (Specify) Reconnected Feeders/Circuits ( ) @ $2 Each
Manufactured Home Park Lot Supply ( ) $35 Each Special Inspection Fee ( ) Hours @ $80 Per Hour
Plus Miles @ The IRS Mileage Rate of
Detached Garage or Other Associated Structure Detached Garage or Other Associated Structure
New Home Service/Power Supply 0-400 ampere @$35 New Home Service/Power Supply 0400 ampere @ $35
New Feeders/Circuits ( ) @ $6 Each New/Extended Feeders/Circuits ( ) @ $6 Each
Other (Specify) Reconnected Feeders/Circuits ( ) @ $2 Each
Other (Specify) State Surcharge = $ 5 . 00 S
TOTAL (the fee calculated above or $35 multiplied by the TOTAL (the fee calculated above or $35 multiplied by the ,—
number of required inspection trips, whichever is eater) number of re wired inspection trips, whichever is greater)
Receipt # ; 6
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 :
Rough4n Inspection (s) Date Walt Lusian, Electrical Inspector
952 . 934 . 0229
Final Inspection Date
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