Permits - Permit# L21-13 - 4750 West Arm Road - 4/7/2021Apri 11, CUC1 aL 1:41:CJ AM LUI
APR-7-20P,1 04:28 FROM:LISKA HOVLAND
/01554Uyiu/ b;f L kecelyea
7635469107 TO:9524427521 P.1/2
CITY OF SPRING PARK
ELECTRICAL PERMIT
opnCL USE ONLY
Electric Permit # L
ex3:Z - 3
Date lssu'Y/� Reccipt #
PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEM$ ON BOTH PAGES
Quantity DESCRIPTION OF WORK FEES Subrrotal
A. MINIMUM FEE PER INVECTION TPJP
—IncludBS up to 4'circuits If more than 4 see Sec. D below _ $ 40.00 per
Inspection trips for Reinspection/Bonding/Equipotential Plane/etc. $ 40.00 per
.
_Additional
B. RESIDENTIAL One and Two-family dwelling units Up to 3 trips Included In fee
1, New Dwelling„Unit, up is and including a 200 amp service $ 125.00 per unit
2. New Dwellin 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 & 0 below but not to exceed $ 125.00 per unit
_
4.- Existing Dwelling Unit, additions, alterations, or repair's 201 amp to 400 amp service
fees as per C-_$ D,below but not tq exceed 175.00 Der unit
5. Now or Existing Dwelling Unit, 401 amp service or above See C & D below
C. FEES FOR NEW OR UPGRADED $ERVICES, TEMP. SERVICES, GENERATORS,
0THAR„1?_QWfJL8MLY SOURCES, OR. FEEDERS TIC 6.EP,u67RUOTURE.S
1. U to and including.a.200_amp service ._.... $ 50.00 each
2.201am to and 400 ....i _._. __._
- am 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 8► TRANSFORMERS
0 to 200 am — _ -- $ 10.00 per circuit
Above 200 am $ 15.00 or circuit
Transformers up to 10 KVA $ 20,00 each
Transfbrmers 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
. WORK BEGUN OR FINISHED WITHOUT PERMIT 1S 2X THE REQUIRED PERMIT FEE
-1.00
State Surcharge .0005 of the permit fee (minimum of $1.00)
TOTAL AMOUNT DUE
(Do not forget State Surcharge Fee)
�1OQ
You must call 952442-7520 when work is ready for inspection!
4
Describe Proposed Work.
Separate Permits are required for any building, mechanical, fire, or plumbing work.
� �,,2
PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEMS ON BOTH PAGES
Job Site: Street Address: �� {� �IiQj�` C VY1 +2j Suring Park. MN Zip'.
OR Legal Description: Lot: Block: Subdivision:
Property ID (PIN No):
Applicant Is: Contractor: IrSV Or Owner: C�
Contractor/Company Name: keij i en L fcf-i cGz r1 L --- License #0
Address:11 �422 City/State:
Telephone: Office/Home: - Mobile:
E-mail: I C Ct. n { 5�('.� . 1'1- Fax:
r n
,Builder/Owner Name: P Ol1
Address (if Jiff. from Site): City/State: — Zip:
Telephone: Office/Home: (�- ? - - Mobile:
E-mail; Fax: (__ � _ -
I HEREBY APPLY VOR AN ELECTRICAL PERMIT, AND I ACKNOWLEDGE THAT THE INFORMATION ABOVE IS COMPLETE AND ACCURATE; I
tJNDT;RSTAND W_ oML is dQX'CQSTAM WI JOUT A PER Ma. I UNDERSTAND AND I EIL?13Y AGREE THAT TH8 WDxK FOR WHICTI THE
PERMIT TS ISSUED SHALL bE PERFORMED ACCORDING TO THE POLLOWINa. (1) THE CONDTTION$ OP'nll, PERMIT, (2) THE APPROVFwD
PLANS AND SPECTFTC:ATTONS, IF N>?E13130 (1) TH9 APPLICkBLE CITY APPROVALS, URn1t4ANcES, AND Cnngs, ANn (4) TNr STATE
T9L.nT.r)TNC,lFT,gCTR1CAL CODE. I UNDERSTAND THAT TH .PeRMrr WILL EXPIRE, AND BECOME NULL AND VOID IF WORK iS.NOT
COMPLETED WITHIN 12 MONTHS OF VALIDATED DATE AND, TIIAT I AM RE5PONSIDLE FOR EPTSUZZ THAT ALL REQUIRM
INSPNC'r10NS ARE REQUESTED IN 9WORMANCE WITH THFs STATE BUILDINGIELECTRICAI. CODE_
Signature:
Date; 14-5 11
PAYMF._NT MUST ACCOMPANY APPLICATIONAPPLICATIOXMc sure to include State Surcharge in payment)
o Check attached Check # MAKE CHECKS PAYABLE to MNSPECT
EMAIL; electrical@a mnspect.eom
FAX: 952-442-7521
MAILMELIVER: MNSPECT, 235 West First Street Araaonia, MN 55387
)d Visa/Master Card —
I
Account Number
Credit. Card Owner Billing Addrosrt: 114,31
S et Address
Expiration aatc
_
C�SV
,/�
1, ...- � .L Y-1—
A
Amount to be withdrawn
Zip Code
city, state
1'syme t uthorization Signature (REQUIRED)
Print Name on credit card (REQUIRED)
%' MNSPECTLLC
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�-----�-� 335 Flrsl SNeef Wesl • Weconia, MN 5538)1382
952-442-7520 Fax 952-442-7521 888-446-1801
Sold To
Kevin Ahlers Electric
Sales Receipt
Date
Sale No.
4/7/2021
7287
Payment Method Check No.
Visa
Description
Qty
Rate
Amount
Electrical Inspection/Permit Fee - L21-13, 4750 West Arm Rd
State Surcharge - Electrical
80.00
1.00
80.00
1.00
Total $81.00