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611ah� <br />3301 Silver Lake Road <br />St. Anthony Village, Minnesota 55418 <br />Office: (612) 782 -3301 <br />Fax: (612) 782 -3302 <br />www.ci.saint-anthony.mn.us <br />F r Office Use Only ubmittal Date <br />Brian Nelson (inspector) 763 -434 -4853 Calls taken between 7 -8:30 am M -F <br />Licensing Requirement: Rough -In Inspection Required? _Y _N <br />Electrical Contractor must be State Licensed Other than Rough -In or Final Inspection <br />and have required insurance paid to date. Ready Now or Date Ready <br />Either Homeowner or Contractor must schedule All Rough -In & Final <br />PROPERTY INFORMATION Property Type: D Residential 0 Commercial 0 Industrial 0 Mufti -Family D Townhouse 0 Duplex <br />Property Address: <br />Owner Name: <br />Phone Number: L ^ 26 0 ^ 7? 72 <br />HOMEOWNER / CONTRACTOR INFORMATION Contractor License # 8_11 J 7 5-6 <br />Applicant Name: 1J110 E/e6 /yt Ste✓4 — , iC ,0 / « <br />Applicant Address: '5-3.5-j- - /GJ- <br />/',LX') xa.4. <br />lt�N- rjJc� <br />Contact Name: i6,1 ✓r,' <br />Phone: 2. 7 <br />_ <br />Fax: <br />/� <br />Work Description: fz{ob w O/W /6e. <br />[77- <br />X, <br />escription <br />Description Continued <br />Fee Totals <br />f Service /power Supply• <br />Feeders /Circuits <br />Circuits <br />p eres <br />$8 0- 30amps <br />=Servim/Power <br />res <br />$10 31 -200 amps <br />Transformers <br />itional loo amps <br />$15101 -200 amp <br />for reconnected ifspliced <br />$5 each additional 100 amps <br />Retro fit Lighting = <br />outside of panel full circuit fee applies <br />$70 /unit Multi - Family Dwellings <br />•includes one inspection trip <br />This does not include the s mia / housing wiring <br />Traffic Signals = <br />Transformers <br />$7 Traffic signals per standard <br />Street/lot lights = <br />$10 0 -10 kilovolt -ampheres <br />$4 Streetlights /lot lights each <br />$40 11- 76kilovolt- ampheres <br />$8 Sign transformers <br />Swimming pools = <br />$80 over 76 kilovolts- ampheres <br />$35 Swimming pools aretripfees +circuitfees <br />$35 Trip fee /Re- inspection /Supplemental trip <br />$100 Investigation fee <br />Total # of Trips = <br />Retro FR Lighting, Remote Control, Signal, <br />New Hong <br />Fire Alarm & Energy Management Devices: <br />$150 Maximum if service is under 200 amps <br />with 3 Inspection trips. If over 200 amps, <br />Investigation fee = <br />$10 0 -10 fixtures <br />no maximum fee <br />$.65 each additional fixture /device <br />Detached building= Service +circuits <br />State Surcharge = $1.0o <br />( ballast& lamps only are newcircuitfee) <br />Remodeled or Total calculated fees: <br />11 <br />Number of trips by $35 or circuitfws <br />1 <br />Total Permit Fee 5! <br />whichever is greater but not both <br />Request for Electrical Inspection with a fee of $250 or less expires 12 months from the filing date. The owner must have the work completed within <br />the 12 month period or submit another REI that includes the inspection fee for the uncompleted work. <br />Inspection fees do not carry over from one <br />REI to another. <br />�' 'M Z, 44/" <br />t4 <br />/�G <br />Applcant /Contractor Signature Dat <br />