HomeMy WebLinkAboutElectrical Permit 12. 298 4 l � Etiv r ��„ z?,e)
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z"...?" CONTRACTOR/REGISTERED EMPLOYER REQUEST FIR
ELECTRICAL INSPECCTH IN
Date Rough -In Inspection Required? Q Yes Inspection Other Than Rough -in: Q Ready Now
Contractor /Employer Must Schedule All Rough -In Inspections Contractor /Employer Must Schedule All Final Inspections
Q Will Schedule
Address of Inspection — Street 35K Project Description:
7 TT//JJ S 4-1_ I 4, tfki.4
Owner Name -- 1 --- ,,,4"p ✓u l C
Owner Phone 6.C.-/ �
Home: Cell: , OZ �u
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Contractor /Registered Employer Name S ( eiGc , 4t Vy / Contractor /Registered Employer Mailing Address
Pig 0c--z{yt,c /c,-, 2 5 RG be- L-1- (4✓& /ecz-Fz.s
Contractor /Employer Telephone Number Contractor /Employer E -mail Address Electrical Utility
Work: Cell:
Z. 1, / ti/A- AAlei C •
Contr tor Em ,toyer A thorized 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 y . 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 @ $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
number of required inspection trips, whichever is greater)
Receipt # 667V l Z
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
• uj -17,5 Order for Payment
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Date Request for InspectioneiLal Number Date Filed
F-Zo-/2.. /2—
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Electrical Cont actor/Installer License Number
• 1 9 ,<0 0 E2-Ec-i
EX az(5 I
Owner/Occupant County
cear exrEkehes E,6o P12.0P6R Jc_Dff
Job Address - Street Ci 1
K CA rt1Z eif 4 ( f/ blec--•
This Order for Payment is for additional fees associated with the above referenced Request for Electrical Inspection.
Fee Calculation/Explanation
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Return this Order for Payment with your check payable to the in the
amount of $ 12,
—
by (fourteen days from the date issued)
A service charge of $30 will be added all dishonored checks.
Inspector ame and umber For Department Use Only
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Inspector Telephone Number
952_ r3ci ozz
Inspector E-mail Address/Website
Inspec or ' natur
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