P - 75650Minnesota De
443 Lafayette
St. Paul, MN
Phone: (65'�
TTY/MRS:�
Date
6/17/2008
:nt of Labor and Industry
North
) 297-4198
state. mn. us
�r Re uest for Electrical Ins
Rough-In Inspection Required?
/1UUIC�J UI II IS�dGIiUUII � JIICGI
5850 2 1/2 STREET NE
Owner Name
DAILEY CONSTRUTION
Owner Telephone Number(s) — Include
Contractor Name
GATOR ELECTRIC, INC
Contractor Telephone
(763) 712�590
23269764
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;tion — One Famil Dwellin 7As3o�ra�. ��,-____.e
Yes Single Inspection OtherThan Rough-In: � Ready Now
:ctions Contractor Must Schedule All Final Ins ections ✓❑ Will Schedule
City/Township County
FRIDLEY ANOKA
ADD OUTLET IN GARAGE FOR OPENER
�ontractor maumg Aaaress
5877 183RD AVE NW, ANOKA MN 55303
_ CQntractor E-mail Addr -cc_ _ __
TDANKERT@GATORELEC.COM
� Contractor License Number Job!
Fee Calculation
New Home or Associated Structure
New Dwelling Service/Power Supply 0— 400 ampere @$35
New Dwelling Service/Power Supply 401 — 800 ampere @$60
Ale... I'l...sll:..n Ce.�.de.�.!l�:.....ia..
to
New Home — More than 30 Feeders/Circuits (in addition to
above) ( ) Feeders/Circuits Ua To 200 A Cc� $6 Each
Detached Garage or Other Associated Structure
New Service/Power Supply 0— 400 ampere @$35
New Feeders/Circuits ( ) @ $6 Each
Other
TIM 763-477-2743
Existing Home/Structure Remodel or Addition
New Service/Power Supply 0— 400 ampere @$35
New Servicz/Power Supply 401 — 800 ampere @$60
IVew�xtended Feeders/Ci?cuits — Up to TSFeeders/Circuits
Feeders/Circuits $6 Each or 16 to 30 $100
New/Extended Feeders/Circuits — More Than 30 Feeders/Circuits
( ) Feeders/Circuits Ua to 200 A C� $6 Each
( Feeders/Circuits $2 Each �
Detached Garage or Other Associated Structure
New Service/Power Supply 0— 400 ampere @$35
New/Ex'iended Feederslti s � , `, _ _ _ _ .
Reconnected Feeders/Circuits ( ) @ $2 Each
.�
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TOtal (the fee calculated above or $35 multiplied TOtal (the fee calculated above or $35 multiplied
by the number of required inspection trips, by the number of required inspection trips,
whichever is greater) whichever is greater) $35 ,
Requests for Electrlcal Inspectlon (REI) wkh a fee of $250 or less explre 12 months from the flling date. The contractor must have the work completed wlth
the 72 month perlod or submlt another REI that Includes the Inspectlon fee for the uncompleted work. InspecUon fees do not carry over from one REI to �� `�
another.
A servlce charge of $30 will be added for all dlshonored checks.
I hereby cerGry that I inspected the elec:trical installation herein on the dates stated: Fr,r n.��n.*..�e�r i iae n.,i.,
Rough — In Inspection(s)
Thls materlal can be made avallable In
TDD (651) 297�198.
REI 02 (6l07)
�ate ,�' � lA�i'� � ��Q
_D�e '1LVU ��� o � �o��
as large print, Brallle or on a tape. To request, call 1-800-342
or