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HomeMy WebLinkAboutElectrical Permit 11.172 :i .! ,, f P tr���! U � , _I.. 0 / �- CI erg "1 °1561 CONTRACTOR /REGISTERED EMPLOYER REQUEST FOR ELECTRICAL INSPECTION Date Rough -In Inspection Required? OK Inspection Other Than Rough -in: Q Ready Now Contractor /Employer Must Schedule All Rough -In Inspecti ns Contractor /Employer Must Schedule All Final Inspections �Q�� QWillSchedule Ad es Inspection – r t ) J�� st L Project Description: Owner Name,_ i�) Owner Ph A z/ J 3 / 3‘ _ Home: � ! Cell: Contractor /Registered Employer Name Contractor /Registered Employer Mailing Address 5:3 4 4, 'irs i't Ai- w e vs F-1 ec-- t' i gl — s 1' st G/ece_, 1, n? Contractor /Employer Telephone Number Contractor /Employer E -mail Address Electrical Utility Work: �l Cell: ,4i1� I / � l� /_ /� C /,Z878 - (/ / Contra c.r /Employer Au hnri7pd_Signature Contractor License Number Job /Project o arrf ct Person: ice. 4 cA0 /3/ — 2cl( 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 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 bap Lcp. 1Z1 3s 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 _ 4 ,. e .. ( ) Additional Circuits Above the 20 Allowed 5 . _ ..�r.. rr. //4, / •� Per unit @ $6 Each a s e s ` I ver 1 kva ( 1 @ e Each TOTAL (the fee calculated above or $35 multiplied by the n �' � 14 (7-- number of required inspection trips, whichever is greater) „f7 — R ol„t 0-.1 0\ 4(-4*°' t l ( .(; . Q) ci / Receint # (p 4 - 7¢ 1 , Requests for Electrical Inspection (REI) with a fee of $250 or less expire 12 months from the filing date. The owner 4 I'„ 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 l t i Ro I VA-140w4.9 Order for Payment Date Request for Inspection Serial Number Date Filed /2 - /p_ // / ei . /2-7- Z01/ Electrical Contractor Installer License Number Owner /Occupant County r F-re-.5 c� / SCe Jo ddress - Street `JJU I�Gi wnship 7 /3Q /5 - 5- gone 41 AL This Order for Payment is for additional fees associated with the above referenced Request for Electrical Inspection. Fee Calculation /Explanation Return this Order for Pa yment with your check payable to them " - • ' in the c ' - --.. amount of $ by (fourteen days from the date issued) A service char. e of $30 will be added for all dishonored checks. Inspector Name and Number For Department Use Only Inspector Tel hone Number 9� Tel 0229 Inspector E -mail Address/Website Inspector gnature U •- vjn II Order for Payment oramiliroimmommrailammiiis Date Request for Inspection Serial Number Date Filed 3 - /y /5 //- o/ /2. -7 -/1 Electrical Contractor /Installer License Number GR b/ r RI V 'L£L7` C4 p/ 3/ 3 Owner /Occupant County f g- i2)Ce" S co i Job Address - Street Git ownship x/30 /50 5' f�ta MA - E This Order for Payment is for additional fees associated with the above refer: •-"=. • uest for Electrical Inspection. Fee Calculation /Expla -` ion Dd 4.4blrrdrn I //Y5,& e'17,WW 35 (Fec4. row__ evf2E) • 00 i CO I Return this Order for Payment with your check payable to the in the _.o -a amount of $ 33 ..- by (fourteen days from the date issued) A service charge of $30 will be added for all dishonored checks. Inspect r Name and Number For Department Use Only Gr Us/.Q/1! gefrourr Inspector Telephone Number sz s ©z 1 ' I 3 q Inspector E - mail Address/Website Z► Inspector S' ature ." r ---.1 •