Electrical Permit - Permit# L 21-29 - 3902 Shoreline Drive - 8/10/2021CITY OF SPRING PARK IOFFICE USE ONLY
ELECTRICAL PERMIT Electric Permit # L �, -z-`t Date Issued: g / t I Receipt #
PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEMS ON BOTH PAGES
Quantity DESCRIPTION OF WORK
FEES Sub/Total
A. MINIMUM FEE PER INSPECTION TRIP
1
Includes up to 4 circuits if more than 4 see Sec. D below $ 40.00 per
40.00
Additional Inspection trips for Reinspection/Bonding/Equipotential Plane/etc. $ 40.00 per
B. RESIDENTIAL One and Two-family dwelling units Up to 3 trips included in fee
1. New Dwelling Unit, up to and including a 200 amp service $ 125.00 per unit
2. New Dwelling Unit, 201 amp to 400 amp service $ 175.00 per unit
3. Existing Dwelling Unit, additions, alterations, or repairs up to & including a 200 amp service,
fees as per C & D below but not to exceed $ 125.00 per unit
4. Existing Dwelling Unit, additions, alterations, or repairs 201 amp to 400 amp service
fees as per C & D below but not to exceed 175.00 er unit
5. New or Existing Dwelling Unit, 401 amp service or above See C & D below
C. FEES FOR NEW OR UPGRADED SERVICES, TEMP. SERVICES, GENERATORS,
OTHER POWER SUPPLY SOURCES OR FEEDERS TO SEP. STRUCTURES
1. Up to and including a 200 amp service $ 50.00 each
2. 201 amp to and inclu ing 400 amp service $ 100.00 each
3. 401 amp to and including 800 amp service $ 200.00 each
4. 801 amp service and above $ 300.00 each
D. FEES FOR CIRCUITS/FEEDERS & TRANSFORMERS
0 to 200 am $ 10.00 per circuit
Above 200 am $ 15.00 per circuit
Transformers up to 10 KVA $ 20.00 each
Transformers over 10 KVA $ 30.00 each
E. MULTI -FAMILY DWELLINGS
Each dwelling unit $ 50.00 per unit
F. ALARM, COMMUNICATION, SIGNALING CIRCUITS, OF LESS THAN 50 VOLTS
Each System Device or Apparatus @ $ .50 each
G. WORK BEGUN OR FINISHED WITHOUT PERMIT IS 2X THE REQUIRED PERMIT FEE
State Surcharge .0005 of the permit fee (minimum of $1.00)
1.00
TOTAL AMOUNT DUE
Do not forget State Surcharge Fee
41.00
$
You must ca11952-442-7520 when work is ready for inspection!
Describe Proposed Work: wiring of Bryant AC
Separate Permits are required for any building, mechanical, fire, or plumbing work.
PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEMS ON BOTH PAGES
Job Site: Street Address: 3902 Shoreline Drive
OR Legal Description: Lot:
Property ID (PIN No):
Applicant is: Contractor: V Or Owner: ❑
Block:
Contractor/Company Name: Pronto Heating & Air Conditioning
Address:7415 Cahill Road
Telephone: Office/Home: ( 952-8 5-7777-
E-mail: permits@prontoheat.com
Builder/Owner Name: Jeff Garberg
Address (if diff. from Site): Same
Telephone: Office/Home: 9( 52-594-0861_
E-mail:
Spring Park, MN Zip: 55384
Subdivision:
City/State: Edina,MN
Mobile: (�
License #: EA77990`g-'
Fax: ()
City/State:
Mobile: (� -
Fax: (�
Lip. 55439
Zip:
I HEREBY APPLY FOR AN ELECTRICAL PERMIT, AND I ACKNOWLEDGE THAT THE INFORMATION ABOVE IS COMPLETE AND ACCURATE; I
UNDERSTAND WORK IS NOT TO START WITHOUT A PERMIT. I UNDERSTAND AND HEREBY AGREE THAT THE WORK FOR WHICH THE
PERMIT IS ISSUED SHALL BE PERFORMED ACCORDING TO THE FOLLOWING: (1) THE CONDITIONS OF THE PERMIT, (2) THE APPROVED
PLANS AND SPECIFICATIONS, IF NEEDED (3) THE APPLICABLE CITY APPROVALS, ORDINANCES, AND CODES, AND (4) THE STATE
BUILDING/ELECTRICAL CODE. I UNDERSTAND THAT THE PERMIT WILL EXPIRE, AND BECOME NULL AND VOID IF WORK IS NOT
COMPLETED WITHIN 12 MONTHS OF VALIDATED DATE AND, THAT I AM RESPONSIBLE FOR ENSURING THAT ALL REQUIRED
INSPECTIONS ARE REQUESTED IN CONFORMANCE WITH THE STATE BUILDING/ELECTRICAL CODE.
Signature:
Date: 8/9/2021
PAYMENT MUST ACCOMPANY APPLICATION (Be sure to include State Surcharge in payment)
❑ Check attached — Check #
MAKE CHECKS PAYABLE to MNSPECT
EMAIL: electrical@mnspect.com
FAX: 952-442-7521
MAIL/DELIVER: MNSPECT, 235 West First Street Waconia, MN 55387
V Visa/Master Card —
Account dumber
Credit Card Owner Billing Address:
Street Address
Payment Authorization Signature (REQUIRED)
$ W-
Amount to be withdrawn
5q3�
City, State Zip Code
Print a on credit card (REQUIRED)
Date CSV
MNSPECTLLC
-- 235 F,If S11— Wes 1 5$38) 1302 „
952-442-7520 Fax 952-442-7521 888-446-1801
Sold To
Pronto Heating & Air
Sales Receipt
Date
Sale No.
8/10/2021
7383
Payment Method Check No.
Visa
Description
Qty
Rate
Amount
Electrical Inspection/Permit Fee - L21-29 - 3902 Shoreline Dr
State Surcharge - Electrical
40.00
1.00
40.00
1.00
Total $41.00