P - 75662liY� , � �
Minnesota De ent of Labor and industry
443 Lafayette oad North
St Paul, M 155-4342
Phone: (6 284-5064
TTY/MRS (651) 297-4198
www.ele 'city.state.mn.us
Contractor Re uest for Electrical Ins
Date Rough-In Inspection Required?
06/23/2008 Contractor Must Schedule All Rou h-In I
Address of Inspection - Street
185 49TH AVENUE NE
Ovmer Name
JOHN BLISH
Owner Telephone Number(s) -
(763) 502-1368
Contractor Name
CENTERPOINT ENERGY
Contractor Telephone Number
(763) 757-6202
tion — One Fam
Yes Single Inspeci
I Contractor Must
City/Township
FRIDLEY
Dwelling/Assc
�her Than Rough-In:
County
ANOKA
WIRE/ RECONNECT FURNACE AND AIR
CONDITIONER
Structure
] Ready Now
] Will Schedule
Contractor Mailing Address
9320 EVERGREEN BLVD NW SUITE B COON RAPIDS, MN 55433
Contractor E-mail Address Electrical Ufilitv
Contractor License Number
CA01796
Fee Calculation
Ne e or Associated Structure
New Dwelling Servi�/Power Supply 0- 40 $35
New Dwelling Service/Power Supply 401 - 800 ampere @$60
New Dwelling Feeders/Circuits
Up to 30 Feeders/Circuits - $100
New Home - More than 30 Feeders/Circuits (in addition to
above) ( ) Feeders/Circuits Ua To 200 A C� S6 Each
Detached Garage or Other Associated Structure
New Service/Power Supply 0- 400 ampere @$35
New Feeders/Circuits ( ) @ $6 Each
---- .-�--••„
Other (Soecifvl
JOANN ZINKEN
Existing Home/Structure Remodel or Addition
New Service/Power Supply 0- 400 ampere @$35
New Service/Power Supply 401 - 800 ampere @$60
New/F�ctended Feeders/Circuits - l ln te 15 FparlArc/Cire� �i+�
Feeders/Circuits @$6 Each or 16 to 30 $100
la�l FPatlorc/('.irei iitc — Mnre Th�n �n Gee.�e.�ir��..� �
Feeders/Circuits U to 200 A $6 Each
Reconnected Feeders/Circuits
2 Feeders/Circuits $2 Each $4
Detached Garage or Other Assoclated Structure
New Service/Power Supply 0- 400 ampere @$35
New/Extended Feeders/Circuits ( ) @ $6 Each
Reconnected Feeders/Circuits ( ) @ $2 Each
Other (SneciNl
� oLa1(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, �S' `7
whichever is greater) whichever is greater)
Requests for Electrfcal Inspectian (REI) with a fee of $250 or less expire 12 months from the flling date. The contraetor must have the work completed within
the 12 month perlod or submft another REI that lncludes the InspecUon 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 certify that I inspected the electrical installation herein on the dates stated: A For De rtment Use Only
Rough - In Inspection(s) Date °l %� � �
��'l09
�
Finallnspection Date , . �� �u� �7 Z00�
� 2,�.---:�.��. �
This material can be made available In dlfferent forms, such as large print, Qrallle or on a tape. To request, call 1-800-342-5354 (DIAL-DLI) Vofce or
TDD (651) 297�L198.
REI 02 (6/0�