Electrical Permit - Permit# L 22-04 - 4201 Sunset Drive - 1/18/2022CITY OF SPRING PARK
ELECTRICAL PERMIT
OFFICE USE ONLY
Electric Permit #
Date Issued: I vU 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
Includes up to 4 circuits if more than 4 see Sec. D below $ 40.00 per
!ap.Ur)
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 per unit
5. New or Existing Dwelling Unit, 401 amp service or above See C & D below
.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 includin 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 CIRCUITSIFEEDERS 8i 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
State Surcharge .0005 of the permit fee (minimum of $1.00)
1.00
TOTAL AMOUNT DUE
Do not forget State Surcharge Fee
' Uv
You must call 952-442-7520 when work is ready for inspection!
Describe Proposed Work: A &1AAL 2QANI.O&E. _
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: q.10/ 5"St'.1' �)r, 4 v Spring Park, MN Zip:
OR Legal Description: Lot:
Property ID (PIN No):
Applicant is: Contractor: �R Or Owner: ❑
Block:
Subdivision:
JDP ELECTRICAL SERVICES S7 &� 4
Contractor/Company Name: 1419 naKpnlAlTS DRNE License #:G t�f
WACONIA, MN 55387
Address:
City/State:
Telephone: Office/Home: C6, Z) (_ - (S2- Mobile: Lgs2)
E-mail: £all - A D ZkhC.UAX9 . US Fax: �) _
Builder/Owner Name: JOP ELECTRICAL SERVICES
1432 OAKPA1PFTEDRIVE
WACONIA, MN 55387
Address (if diff. from Site):
City/State:
Telephone: Office/Home: ( l Z) `Z S ( - y 1 SZ Mobile: q( 51 ) dy-\, - O;��
E-mail: ,CaV-Etfl 0 �t d n �&e-CrQe- . U.S Fax: (�
Zip:
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
BUILDINGIELECTRICAL 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 1 AM RESPONSIBLE FOR ENSURING THAT ALL REQUIRED
INSPECTIONS ARE RE0JJ9&T-EIJ IN CONFORMANCE WITH TIJE STATE BUILDING/ELECTRICAL CODE.
Signature:
Date: Ild �Z
PAYMENT MUST ACCOMPANY APPLICATION (Be sure to include State Surcharee in navment
❑ Check attached - Check # MAKE CHECKS PAYABLE to MNSPECT
EMAIL: electrical@mnspect.com
FAX: 952-442-7521
MAILMELIVER: MNSPECT, 235 West First Street Waconia, MN 55387
Visa/Master Card - _ _ _ _ _ _ $ lie (. Up
Account Number� Expiration Date CSV Amount to be withdrawn
Credit Card Owner Billing Address: 14 3a U ( (xj( [ h- \0CjLC-GUI rA— � ' l i S(�?:9:Z
Street Address City, State Zip Code
Ly.1 iA tAmN L. wkLKeg,
Payment Authorization Signature (REQUIRED) Print Name on credit card (REQUIRED)
MSP EC�T,-
952-442-7520 Fax 952-442-7521 888-446-1801
Sold To
JDP Electrical
Sales Receipt
Date
Sale No.
1/18/2022
7529
Payment Method Check No.
Visa
Description
Qty
Rate
Amount
Electrical Inspection/Permit Fee - L22-04 - 4201 Sunset Dr 4507
State Surcharge - Electrical
80.00
1.00
80.00
1.00
Total $81.00