HomeMy WebLinkAboutElectrical Permit 12. 413 A yy
J
Pitlp$t
V earl
��!NNES CONTRACTOR/REGISTERED EMPLOYER REQUEST FOR
ELECTRICAL INSPECTION
Rough-In Inspection Required? Yes Inspection OtherThan"Rough-in: 0 Ready Now
1 L Contractor%Employer Must Schedule All Rough-In Inspections Contractor/Employer Must Schedule All Final Inspections
0 Will Schedule
inspection — Street Project Description:
ne g Gti+ m� d ThOAI 1 uld \ t I� loom [
me
Cell;
Gri
)Registered Employer Name WContractor/Registered Employer Mailing Address
32P - ag3 , Vo 3 S MIe d
prw. tlt elrt ` ' cam &+1 -Co 'f0� � Mbt< Cl Jeri L� nllc•i rvliv5S31$
/Employer Telephone Number Contractor/Employer E-mail Address Elect. I utility
Q / Cell :
Ai ployer Authorized Signature Contractor License Number Job/Project Contact Pierson :
^f 1�
FEE 'CALCULATION
ewer Supply 0-400 ampere @ $35 Technology Systems Devices ( ) @ $ .75. Each
ower Supply 401 - 800 ampere '@ $60 Separate Bonding Inspections for Swimming Pools and
E ui otential Planes I @ $35 Each
ower Supply Above 800 ampere @ $100 Center Pivot Imgation Booms .( ) @ $35 Each
Plusf 1131ectrical Drive Units @ $5 Each
nded Feeders/Circuits Up to 200 A ( ) @$6 Each Luminaire Retrofit Modifications ( ) @ $.25 Each
,Ircuits Above 200A ( ) @ $iS Each Concrete-Encased Electrode Inspection ( ) @ $35 Each
tedfeeders/Circuits ( ) @ $2 Each Investigative Fee $70 Or The Total Inspection Fee,
1Nhicheveris Greater Up to $13000
ired Home Park Lot Supply ( ) @ $35 Each Special Inspection Fee ( ) Hours @ $80 Per Hour
Phisf I Miles @ The Inc: Mileage Rate of
dal Vehicle Site Supply Equipment
Us Originating in the Equipment @ $6 Each Other t vi v0, 4 J�
rkingLot, LighdngStandard ( ) @ $SEach Over 600 Volts - Add the combined service/powersupplyand
feeder/circuit fee to result in double the regular fee (does not
apply to electric sign and outlineli tin
tiers Up to l0 kva ( ) @ $15 Each ( ) New Multi-Family 1)w'ellings @ $70 Each
00 State Surcharge of $5.00
�I749
2 '25 ( ) Additional Circuits Above the 20 Allowed
( J J Per unit @ $6 Each
ners Over 10 kva ( ) @ $30 Each TOTAL (the fee calculated above or 05 multiplied by the
number ofrequired i ection trips, whichever is eater
Receipt #
gists for Electrical Inspection (REI) with a fee of $250 orless expire 12 months from the filing date. The owner
ave the work completed within the 12 month period or submit another REI that includes the inspection fee for
ncompleted work. Inspection fees do not carry over from one REI to another. A service charge of $28 will be
added for all dishonored checks.
r certify that I inspected the electrical installation herein on the
ated:
In Inspection (s) Date Walt Lusian, Electrical Inspector
952.934.0229
spection Date
tan nauic, min 000" �owo I V ,. .
Tel. (952) 934-0229 Mon .-Fri.
Carder for Payment
Date Request for Inspection Serial Number Date Filed
Electrical Contractor/installer / License Number
Owner/Occupant County
Job Address - Street Ci ownship
This Order for Payment is for additional fees associated with the above referenced Request for Electrical Inspection .
Fee Calculation/Explanation
- INspit -'T 6) 'V
S Pp � 7 & 3T
t w cti CL46ct4.
Return this Order for Payment
yent with your check payable to the in the
amount of $ � � by (fourteen days from the date issued )
A service charge of S30 will be added for all dishonored checks.
Inspector Name and Number For Department Use Only
Inspector Telephone Number
Inspector IMVI Address site
Inspector Signature