HomeMy WebLinkAboutElectrical Permit 12. 254 - 1 ' Ri p�
�:. I PERMIT # 12- ,<S r
%v ' or
t` CONTRACTOR /REGISTERED EMPLOYER REQUEST FOR
ELECTRICAL INSPECTION
Date Rough -In Inspection Required? Q Yes Inspection Other Than Rough -in: 0 y Read Now
/ / Contractor /Employer Must Schedule All Rough -In Inspections Contractor /Employer Must Schedule All Final Inspections
! / Z- Will Schedule
Ad ess f spection - Street � Schedule
5 - 3 Project Description: «� / ' '_ T`
Owner Na `' � 1 .A.17 72 , 4 -it/44t, ‘7'. �C �l � `'
Owner Phone d f. 7 a/46./..8. -17404,.. 0
Home: Cell: / 5� -' 90 �C /
Contractor /Registered Employer Name Contractor /Registered Employer Mailing Address
Re ELECTRIC, INC.
Contractor /ErnWEV /� �l ry R MN 5VE. NV 77 tractor /Employer E -mail Address Electrical Uti ' ' g) 7 l7 14 EL . . _ 6
INC. work: AN 1VE 2ND AV NW
DO VER, MN 55304 7?
Contractor /Employer Authorized Signature Contractor License Number
Job /Project Contact A Person: N
FEE CALCULATION
Service /Power Supply 0 -400 ampere @ $35 Y �, v Technology Systems Devices
ces ( ) @$.75Each
Service /Power Supply 401- 800 ampere @ $60 Separate Bonding Inspections for Swimming Pools and
C
Service /Power Supply Above 800 ampere @ $100 Center tential Planes ( ) @ $35 Each
Center Pivot Irrigation Booms ( ) @ $35 Each
, ` Plus ( ) Electrical Drive Units @ $5 Each
New /Extended Feeders /Circuits Up to 200 A
(�1) @$6 Each Luminaire Retrofit Modifications
((( Yc d L ( ) @ $.25 Each
Feeders /Circuits Above 200A ( ) @ $15 Each Concrete- Encased Electrode Inspection P ( ) @ $35 Each
Reconnected Feeders /Circuits 1Gi ) @ $2 Each
F� ' ` .,,> Investigative Fee $70 Or The Total Inspection Fee,
Manufactured Home Park Lot Supply � Whichever is Greater Up to $1,000
PP y ( ) @ $35 Each Special Inspection Fee ( ) Hours @ $80 Per Hour
Recreational Vehicle Site Su PP Y I E ui ment Plus ( ) Miles @ The IRS Mileage Rate of ( )
4 P
( ) 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 ( ) @ $15 Each apply to electric sign and outline lighting)
( ) New Multi- Family Dwellings @ $70 Each
( () State Surcharge of $5.00 _5":"‘-c-)
( ) Additional Circuits Above the 20 Allowed
Transformers Over 10 kva Per unit @ $6 Each
( ) @ $30 Each TOTAL (the fee calculated above or $35 multiplied by the ,,
number of required inspection trips, whichever is greater) /�. , .N
Receipt # (0
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
Final Inspection Date 952.934.0229