Permits - Permit# L18-26 - 2433 Black Lake Road - 1/1/2018Nov, 9. 2018 9:04AM Electric City Corp
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No, 0862 P. 1/1
CITYCIF SPRING PARK OFFICE USE ONLY
Electric Permit # L t - ZJ�
ELECTRICAL PERMIT natcInued: it - Acceipt# 0-
PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEMS ON BOTH PAGES
Quantity DESCRIPTION OF WORK FEES Sub/Total
MINI.Ml7NIFpER=11�lSFEC110N_xRIE_.=-_ —��
Includes up to 4 circuits if more than 4 see Sec. D below $ 40.00 per
Additional Inspection trips for Reinspection/Bonding/Equlpotential plane/etc. $ 40.00 per
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BB., ly e�t�T
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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 pgr C & D below but not to exceed 175.00 Der unit
5. New or Existing Dwelling Unit, 401 amp service or above See C & D below
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UPGRADED$ERNIC TMP.-;:. =Sx _ r
_�- ... - S,ERVItES;:
:- ORES:.
SU p.(JVN�R-P ,LY�SOURCES -O�R I�bFiRS=TO_ EP_ STRUC;
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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
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IRCUITS FEEDS TRANS.FO — - _
D:;-SEES=FOR�,C RMERS - - — - — - - - --
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
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U - I-:AMILY:AV.1fELLINGS_:::-----:-.,:...-_.::_;_...:.....,__.,:.--,_-:— ---- =- - - _ --- - —=
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Each dwelling unit $ 50.00 per unit
. ALARM, COMMUNICATION; SIGNALING'CIRCUITS; OF'LESS•THAN 50 VOLTS.
Each System Device or Apparatus @ $ .50 each
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INSPECTIONS
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Hourly charge $ 57.00 per hour
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State Surcharge .0005 of the permit fee (minimum of $1.00)
1.00
TOTAL AMOUNT DUE
(Do not forget State Surcharge Fee
$ Q I
You must call 952-442-7520 when work is ready for inspection!
Describe Proposed Work:
Separate Permits are required for any building, mechanical, fire, or plumbing work.
Nov. 9. 2018 9:03AM Electric City Corp No,0861 P. 1
q 00Q.l1
PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEMS ON BOTH PAGES
Job Site: Street Address: 3L y 33 UQkV � �QLAU 0 prin Park, MN Zip: J L
OR Legal Description: Lot:
Property ID (PIN No):
Block:
Subdivision:
Applicant is: Contractor: 9� Or Owner: ❑
Contractor/Company Name; License #;
Ir-
Address:; Kr rn AU-P_ City/State: a ,�11 S Q t .r Zip:
Telephone: Office/Home: A t-;A) �4 -U U Mobile:
E-mail: cx-ym Fax:
Builder/Owner Name:
Address (if Jiff. from Site): 01X "3'j `��cs,Cx >(ji�p_c� City/State: SU1 M Zip;GJCL
Telephone: Office/Home:W�, LVNI - i Mobile:
E-mail: Fax:
111LRPB'Y APPLY FOR AN ELECTRICAL PERMIT, AND I ACKNOWLEDGE THAT THE INFORMATION A 30'VB IS COMPLETE AND ACCURATE; I
UNDERSTAND WORK IS NOT TO START WITHOUT A PERMIT. 1 UNDERSTAND AND HEREBY AGREE THAT THE WORK FOR WHICH THE
PERMIT IS ISSUED SHALL BB PERIrORMED ACCORDING TO THE FOLLOWING: (1) THE CONDITIONS OF THE PERMIT, (2) THE APPROVED
PLANS AND SPECIFICATIONS, IC NEEDED (3) TM APPLICA13LE CITY APPROVALS, ORDINANCES, AND CODES, AND (4) THE STATE
BUILDYNOML13CTRICAL CODE. I UNDERSTAND THAT THE PEILVIIT WILL EXPIRE, AND BECOME NULL AM VOID IF WORK IS NOT
C0\9PLCTED WITHIN 12 MONTHS OF VALIDATED DATE AND, THAT I Ad I RESPONSIBLE FOR ENSURING THAT ALL REQUIRED
INSPECTIONS ARE RROMSTED IN CONFORMANCE WITH THE'STATE BUIL.DIN"LI?CTRICAL CODE.
Signature: Yw-' P'L Date:A 0. V
PAYMENT MUST ACCOMPANY APPLICATION Be sure to include State Surcharge in payment),
❑ Check attached— Clieck # MAKE CHECKS PAYABLE to MNSPECT
MAIL: MNSPECT, P.O. Box 342, 'W'aconia, MN 55387
FAX: 952-442-7521
DELIVER: MNSPECT, 235'West First Street Waconia, MN 55387
Visa/Master Card
Account Number l ,�— flY xpiration ntc CSV Amount to be withdrawn
Credit Card Owner Billing Address: �Z� V Cd R(U S 4_1 S
Street Address City, State Zip Code
n �F• �.�1,
Paymen *Author�17,AadW-n Signature (REQUIRED) Print Name on credit card (REQUIRED)
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; , MNSPECT.
�-----% 3J5 firfl Slresl Wael • Weconla. MN JSJBI-rJ03
952-442-7520 Fax 952-442-7521 888-446-1801
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Electric City
Sales Receipt
Date
Sale No.
11/15/2018
6062
Payment Method Check No.
Visa
Description
Qty
Rate
Amount
Electrical Inspection/Permit Fee - L18-26, 2433 Black Lake Rd
State Surcharge - Electrical
40.00
1.00
40.00
1.00
Total $41.00