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Electrical Permit - Permit# L22-13 - 4310 Shoreline Drive - 3/30/2022 CITY OF SPRING PARK OFFICE USE ONLY ELECTRICAL PERMIT Electric Permit# L zz 13 Date Issued: 3/34e 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 Includes up to 4 circuits if more than 4 see Sec. D below $40.00 per 90 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 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 including 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 amp $ 10.00 per circuit ... Above 200 amp $ 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,© State Surcharge .0005 of the permit fee (minimum of$1.00) 1.00 TOTAL AMOUNT DUE $ -- /' (Do not forget State Surcharge Fee) You must call 952-442-7520 when work is ready for inspection! Describe Proposed Work: ,�1 �.., �, i' om 4, ,*�,.) S ,�,�, N-,..-r 41% Lam, 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: 431 'J�^„o e.�;�� D c Spring Park, MN Zip: S53 9 OR Legal Description: Lot: Block: Subdivision: Property ID (PIN No): Applicant is: Contractor: N. Or Owner: 0 Contractor/Company Name: R'SE a v}r l ("AL License#: C A ie' 3 c Address:l?`"l 03 Derr Lan City/State: 'ogc....o,,,,} / }")-) Zip: 65 0 Telephone: Office/Home: (�)Z. D.05 - ► o 4 Mobile: ((,‘Z,, ) Za5 - >3 oy E-mail: r y i.'t(tc it r t.-�?+* c) , cap* Fax: ( ) - Builder/Owner Name: (..9r to,.} cu,k(As 1 - Poi e- Address(if diff. from Site): City/State: Zip: Telephone: Office/Home: (a').) - aly L. Mobile: ( ) - E-mail: Fax: ( ) - 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 �/e 3e,le, Date: �/' PAYMENT MUST ACCOMPANY APPLICATION (Be sure to include State Surcharge in payment) o 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 �tea Vis. ? $ .\ 21 Account Number Expiration Date CSV Amount to be withdrawn Credit Card Owner Billing Address:‘34 03 CX: r, ,Len + f �N SS c C a Street Address City,State Zip Code aym uthorization Signature(REQUIRED) Print Name on credit card(REQUIRED) M NSPECTLLC Sales Receipt HELPING YOU COMPLY WITH THECODoE Date Sale No. 952-442-7520 Fax 952-442-7521 888-446-1801 3/30/2022 7593 Sold To RJE Electric • Payment Method Check No. MasterCard Description Qty Rate Amount Electrical Inspection/Permit Fee-L22-13-4310 Shoreline Dr 40.00 40.00 State Surcharge-Electrical 1.00 1.00 Total $41.00