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HomeMy WebLinkAboutElectrical Permit 12. 076 Minnesota Department of Labor and Industry //6 �rY" �� - 6 1 52- 3 Z 43 _afavette Road North / " c St. Paul. MN 55155 -4342 Phone: (651) 284 -5026 Permit Number /� 7� wwv,.dii.mn.cov / Contractor or Registered Employer Request for Electrical inspection Form CDA ` Type: All electrical work other than dwellings FELE NON - DWELLING] " S DATE Permit 9 gyp.. 2' 2 .1 a r Site Code Propertv'Job Site dres- ; Site City Site Township Site unty 5`0 .Ad0 )bo St 54 Z. ! kr;ur LK -3 Co- ff ' Ow Name I Owner Phone Owner Cell Owner E -mail vC Kt I Company Type Icneck one box) Company L tense /Reef r tion Number 1 Company Name C Electrical a Type lone Contractor F- D 499.5 jam. T REME ELECTRICAL SERVICES ❑ Technology System Contractor Company Address City State yip Code ❑ Recistered Empiover 31 W RAILRO.AD STREET ,NORWOOD -YA MN 55368 ❑ Class E installer , Company Phone 'Company Cell Company E -mail Company Contact Person and Phone Number (952) 466 -5777 adam @xtremeelectricalservices.cc • Permit Sub -Type (check one x) ❑ Agricultural "ommercial ❑ Government ❑ Industrial ❑ Institutional ❑ Recreational ❑ Technology Project Snort Description Project Long Description a C;rcv ;1t 5/ , ' 6.4)4)e Single Inspection Other tnan Rough -in? Rough -in Inspec tiion / % �� f1 fu �� re /0e« D" Ready Now i✓ Will Schedule ❑ Yes loo Eiectrica! Utility Job Site Contact Person Directions to Job Site 0 to 400 Amp Power Source ( ) @ $35 Street, Parking Lot, Outdoor, Traffic Standards ( ) @ 85 4 01 - 800 Amp Power n Source ( ) ta - , $60 Transformer Light Heat & Power up to 10KVA ( ) @ 81 5 Over 800 Amp Power Source ( ) @ 8100 Transformer Light Heat & Power over 10KVA ( la 830 0 to 200 Amp Circuit or Feeder ( ) @ a 86 Power Supplies for Signs & Outline Lighting ( ) @ 85 Over 200 Amp Circuit or Feeder ( ) @ $15 c Tech Circuits & Circuits less than 50 Volts ( ) @ 75 Reconnect Circuit or Feeder ( ) @ 82 _ Center Pivot Irrigation Booms ( ) @ 835 Separate Bonding Inspection ( ) C a 835 Center Pivot Irrigation Drive Units ( ) @ $5 Insp of Concrete- encased Grounding Electrode ( ) @ 835 Retrofit of Existing Lighting Fixtures ( ) @ 250 0 to 400 Amp Power Source over 600V ( ) @ 870 Inspection Hourly Rate ( ) @ $80 401 - 800 Amp Power Source over 600V ( ) @ 8120 Inspection Mileage Rate ( ) miles © KO Over 800 Amp Power Source over 600V ( ) @ $200 Supplemental Fee ( ) @ 835 U to 20U Amp L Ircult or reeler over bUUV ( )"@"1-12H 'feirispeetitm"Fee'( )' - Investigation Fee (A minimum of 870, or equal to the total Over 200 Amp Circuit or Feeder over 600V ( ) @ $30 inspection fee. whichever is greater, not to exceed 81000) TOTAL FEE is the fee calculated above or $35 multiplied by 3 00 Reconnect Circuit or Feeder over 600V ( ) @ $4 the number of re.uired inspection tri.s. whichever is greater. A surcharge of $5 is imposed on every permit effective 85,00 Manufactured Home Park Lot Supply ( ) @ 835 7/1/10 as per M.S. § 326B.148 Recreational Vehicle Site Circuits ( ) @ 86 Sum :fees 1 Grand Total Requests for Electrical Inspection (REI) with a fee of 8250 or Tess expire 12 months from the filing date. The installer 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 riot carry over from one REI to another. A service charge of 830 will be added for all dishonored checks. I hereby certify that I inspected the electrical installation herein on the dates stated: For Department Use Only Rough - In Inspection(s) Date Final Inspection Date This material can be made available in different forms, such as large print, Braille or on a tape. To request, call 1 800.342 - 5354 (DIAL Voice or TDD (651) 297 - 4198. REI 07 (7/10) REI 07 Contractor Non Dwelling.doc (Revised 7/1/10)