The URL can be used to link to this page

Electrical Permit - Permit# L22-25 - 4768 West Arm Road - 11/7/2022 CITY OF SPRING PARK OFFICE USE ONLY Electric Permit# LZZ-Z-S ELECTRICAL PERMIT Date Issued: i t 7 ZZ Receipt# PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEMS ON BOTH PAGES Quantity DESCRIPTION OF WORK FEES Sub/Total :MINIMIJM FEE:PER INSPECTION,T.RIP Includes up to 4 circuits if more than 4 see Sec. D below $40.00 per Additional Inspection trips for Reinspection/Bonding/Equipotential Plane/etc. $40.00 per B.RF_SIEIENT)AL 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, O_R 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 am $ 10.00 er 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 ALARM,COMMUNICATION, SIGNALING CIRCUITS, OF LESS THAN 50 VOLTS Each System Device or Apparatus @ `} ©©© $ 50 each it State Surcharge .0005 of the permit fee (minimum of$1.00) 1.00 TOTAL AMOUNT DUE (Do not forget State Surcharge Fee �F You must ca11952-442-7520 when work is ready for inspection! Describe Proposed Work: Eq" Separate Permits are required for any building,mechanical, fire, or plumbing work. n116 PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEMS ON BOTH PAGES Job Site: Street Address: '"f"Z� sr� kklef�— � Ej Spring Park,MN Zip: OR Legal Description: Lot: Block: Subdivision: Property ID(PIN No): Applicant is: Contractor: ] Or Owner: ❑ � Contractor/Company Name: C. ElsCQ) License#:I��-('X�I Qu Address: W� City/State: Zip:5539 Telephone: Office/Home: r24a( Mobile: C715 g E-mail: Fax: Builder/Owner Name: re) Address(if diff. from Site): ,�// lCit\�y/S��t��a��t''e:: Zip: Telephone: Office/Home: �) - Mobile: (CL13J �� 7 - 04 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 DE. I UNDERSTAND THAT THE PERMIT WILL EXPIRE,AND BECOME NULL AND VOID IF WORK IS NOT COMPLETED WITHIN 12 ONTHS OF VALIDATED DA E AND,THAT I AM RESPONSIBLE FOR ENSURING THAT ALL REQUIRED INSPECTIONS ARE PQ STED IN CO ORMANCE ITH E BUILDING/ELECTRICAL CODE. Signature: Date: a PAYMENT MUST ACCOMPANY APPLICATION(Be sure to include State SurcharEe 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 Visa/Master Card—_ _ $ �Acccoounnit Number v F ,^Expiration Date CSV Amount to be withdrawn Credit Card Owner Billing Address: 4t_/7 #pLU� Street Address City,stab Zip Code *wo' / C�_ A ic, Pay uthorization Signature(REQUIRED) Print Name on cred c d(REQUIRED) �N�S�PE�1�TLLc Sales Receipt pp6 Date Sale No. 952-442-7520 Fax 952-442-7521 888-446-1801 11/8/2022 7785 Sold To West Star Electric Payment Method Check No. Visa Description Qty Rate Amount Electrical Inspection/Permit Fee-L22-25-4768 West Arm Rd 50.00 50.00 State Surcharge-Electrical 1.00 1.00 Total $51.00