HomeMy WebLinkAboutElectrical Permit 12. 0010 OF PRIp�
PERMIT # 1P ' 0 / 0
J � n
°,"` r CONTRACTOR/ REGISTERED EMPLOYER REQUEST FOR
ELECTRICAL INSPECTION
Date Rough- In Inspection Required ? ® ye Inspection Other Than Rough-in : a Ready Now
Contractor/Employer Must Schedule All Rough-In Inspections Contractor/Employer Must Schedule All Final Inspections
IN Will Schedule
Address of Inspection — St r et Project Description :
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Owner Name AJ
Owner Phone
Home : Cell:
Contractor/Registered Employer Name Contractor/Registered Employer Mailing Address ' ]
S E= � iCC - n L, ti L U 3 ��, + 1, Sf 4 (eN
Contractor/Employer Telephone Nu ber Contractor/Employer E-mail Address Electrical Utility
Work: Cell :
"1 _-3 � - 2a i 12 - 75 Imo / f // &/;v � - e a - C..
Contra It Authorizod Signature Contractor License Number Job/Project Contact Person: /
EA 7 �
FEE CALCULATION
Service/Power Supply 0400 ampere @ $ 35 Technology Systems Devices ( ) @ $ 35 Each
Service/Power Supply 401 - 800 ampere @ $60 Separate Bonding Inspections for Swimming Pools and
E ui otential Planes @ $ 35 Each
Service/Power Supply a $ 100 pl j j Center Pivot Irrigation Booms ( ) @ $35 Each
&j Plus Electrical Drive Units @ $5 Each
New/Exten ed F ders/Circuits Up to 200 A ( ) @$6 Each urninaire Retrofit Modifications ( ) @ $. 25 Each
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Feeders/C rcui 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 101wa ( ) @ $ 15 Each ( ) New Multi-Family Dwellings @ $70 Each
( &State Surcharge of $ 5 . 00
( ) Additional Circuits Above the 20 Allowed
Per unit @ $6 Each
Transformers Over 10 kva ( ) @ $30 E h TOTAL (the fee calculated above or $35 multiplied by the /
number of required inspection trips, whichever is greaterl / Cy
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?jZ• Receipt #Requests for Elec cal Insction (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
Order for Payment
Date Request for Inspection Serial Number Date Filed
Electrical Contractor/installer License Number
\T7 FF"4!i�h/ " SEC l R /
Owner/Occupant County
Job Address - Street n Cit ownship
This Order for Payment is for additional fees associated with the above referenced Request for Electrical Inspection.
Fee Calculation/Explanation
DDI
ors
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Return this Order for Payment with your check payable to the ill W IM W, I MOM in the
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amount of $ l �_ by (fourteen days from the date issued)
A service charge of $30 will be added for all dishonored checks.
Inspecto Name and Number For Department Use Only
Inspector Telephone Number
02_ z7 1
Inspector E-mail AddressMebsite
Inspe tor -gnature
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100000
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