Permits - Permit# L20-19 - 4317 Channel Road - 1/1/2020-7 U��� c4r
CITY OF
ELECTR iCAL
PLEASE PRINT
PRING PARK U1't1%_L UJC UNL7
Electric Permit # L -
PERMIT !Ao l`(
Date Issued: � 1� � Receipt
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
Additio
ial 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 Dwellinp
Unit, up to and including a 200 amp service $ 125.00 per unit
......... .
i
2. New Dwelling
............._- ._ —
3. Existi I
fees as
Unit, 201 amp to 400 amp service $ 175.00 per unit
_
g Dwelling Unit, additions, alterations, or repairs up to & including a 200 amp service,
per C & D below but not to exceed $ 125.00 per unit
'
4. Existing
fees ads
Dwelling Unit, additions, alterations, or repairs 201 amp to 400 amp service
Der C & D below but not to exceed 175.00 Der unit
j
5. New or
_ _
Existing Dwelling Unit, 401 amp service or above See C & D below
C. FEES
OTHE
OR NEW OR UPGRADED SERVICES, TEMP. SERVICES, GENERATORS,
POWER SUPPLY SOURCES OR FEEDERS TO SEP. STRUCTURES
1. U to sand
including a 200 amp service $ 50.00 each
2. 201 ap
to and including 400 amp service $ 100.00 each
3.401 amp
to and including 800 amp service $ 200.00 each
4. 801 a
p service and above $ 300.00 each
D. FEES
OR CIRCUITS/FEEDERS & TRANSFORMERS
0 to 260
amp $ 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. MULT
-FAMILY DWELLINGS
Each
welling unit $ 50.00 per unit
F. ALAR
, COMMUNICATION, SIGNALING CIRCUITS, OF LESS THAN 50 VOLTS
Each
ystem Device or Apparatus @ $ .50 each
G. WORM,
BEGUN OR FINISHED WITHOUT PERMIT IS 2X THE REQUIRED PERMIT FEE
State Surcharge .0005 of the permit fee (minimum of $1.00)
TOTAL AMOUNT DUE
not for eg t State Surchar a Fee
1.00
�00
r�
You
Describe Proposed
must call 952-442-7520 when work is ready for inspection!
Work: (1�� �� 1 � T*f"c \
Se Irate Permits are required for an building, mechanical fire or plumbing work.
P q Y g> P g
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PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEMS ON BOTH PAGES
Job Site: Strut Address: (_\C)r (--)t-jC\ 'V-A Spring Park, MN Zip: 5 53H
OR Legal Description: Lot: Block: Subdivision:
Property ID (P No):
Applicant is: Contractor: Or Owner: ❑
Contractor/Company Name: P e y, License #-EN 01,0gbcl 7
Address: y jAm6eo, Ln City/State: Cvv'('�C" Zip:55 6
Telephone: Off ce/Home: (c`1S), Mobile:( ) -
E-mail:
Fax: ( ) -
Builder/Owne>l Name: CYV
Address (if diff. from Site): City/State: Zip:
Telephone: Office/Home:
E-mail:
1 HEREBY APPLY F
UNDERSTAND WC
PERMIT IS ISSUED
PLANS AND SPECI
BUILDING/ELECT]
COMPLETED WITF
INSPECTIONS
Signature:
o Check attac
EMAIL: el
FAX: 952-
;K' Visa/Master
Credit Card
Payment
Mobile:
Fax: (_) -
AN ELECTRICAL PERMIT, AND I ACKNOWLEDGE, THAT THE INFORMATION ABOVE IS COMPLETE AND ACCURATE; I
IS NOT TO START WITHOUT A PERMIT. I UNDERSTAND AND HEREBY AGREE THAT THE WORK FOR WHICH THE
ALL BE PERFORMED ACCORDING TO THE FOLLOWING: (1) TI IE• CONDITIONS OF THE. PERMIT. (2) THE APPROVED
'ATIONS, IF NEEDED (3) THE APPLICABLE CITY APPROVALS, ORDINANCES. AND CODES, AND (4) THE STATE
AL CODE. I UNDERSTAND THAT THE PERMIT WILL EXPIRE. AND BECOME NULL AND VOID IF WORK IS NOT
12NTH F VALIDATED DATE AND, THAT 1 AD1 RESPONSIBLE FOR ENSURING THAT ALL REQUIRED
iOUESIrEDINCONFORMANCE WITH THE STATE BUILDING/ELECTRICAL CODE.
Date: q T / v
T ACCOMPANY APPLICATION (Be sure to include State Surcharge in payment)
3 — Check # MAKE CHECKS PAYABLE to MNSPECT
rical@mnspect.com
-7521
'ER: MNSPECT, 235 West First Street Waconia, MN 55387
1rd —
Account Number Expiration Date CSV Amount to be withdrawn
3rress: H(Al Arm. ne S Ln ima -5531
Street Ad s City, State Zip Code
ization Signature (REQUIRED) Print Na4 on creJit card (REQUIRED)
r
�MNSPECT�
--.� 221 Firs, SNesf Wsaf • Wec -, MN W 1202
952-442-7520 Fax 952-442-7521 888-446-1801
Sold To
Amek Electric
Sales Receipt
Date
Sale No.
9/15/2020
7090
Payment Method Check No.
Visa
Description
Qty
Rate
Amount
Electrical Inspection/Permit Fee - L20-19
State Surcharge - Electrical
125.00
1.00
125.00
1.00
Total $126.00