P - 75503Minnesota Department o bor and Industry
443 Lafayette Road
St. Paul, MN 55 � 342
Phone: (651 5064
TTY/MRS: 1) 297-4198
www.ele city.state.mn.us
Contractor Re uest for Electrical I
Date Rough-In Inspection Required?
7/3/08 ConVactor Must Schedule All Rougl
Address of Inspection - Street
1330 52ND AVE
Owner Name
BLACKRIDGE BUILDERS
ClwnorTalonhnna Ni�mharfsl _ I
(612) 850-7421
7
1` 1551
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- - ---- _ ------ '�
___
tion - One Famil Dwellin /Associ
Yes Single Inspection Other Than Rough-In:
:ctions Contractor Must Schedule All Final Ins cti
City/Township County
FRIDLEY ANOKA
WIRE 3RD STALL GARAGE ADDITION
Contractor Name Contractor Mailing Address
MEYER BROS ELECTRIC INC P.O. BOX 705 ALBANY, MN 56307
�racture
Ready Now
Will Schedule
on rac or icenselVamBer--�- � —
CA02235 PETE MEYER/ 763-286-5656
� �� � �
Fee Calculation � , '�
New Home or Associated Structure
New Dwelling Service/Power Supply 0- 400 ampere @$35
New Dwelling Service/Power Supply 401 - S00 ampere @$60
to
New Home - More than
To 200 A
�w,��� -
ition to
Detached Garage or Other Associated Structure
New Service/Power Supply 0- 400 ampere @$35
New Feeders/Circuits
Other (Specify)
Other
( ) @ $6 Each
Existing Home/Structure Remodel or Addition
New Service/Power Supply
New Service/Power Supply
4
0 - 400 ampere @ $35
401 - 800 ampere @ $60
ts - iJp ta 15 Feedersl�ircuits
$6 Each or 16 to 30 @$100
- More Than 30 Feeders/Circui
�ts Uo to 200 A(�D $6 Each
Detached Garage or Other Associated Structure
New Service/Power Supply 0- 400 ampere @$35
New/Extended Feeders/Circuits ( ) @ $6 Each
Reconnected Feeders/Circuits ( ) @ $2 Each
$24
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, $35 S D
whichever is greater) whichever is greater) °
Requests for Electrlcal Inspection (REI) wlth a fee of $250 or less expire 12 months from the flling date. The contractor must have the work completed within
the 12 month period or submk another REI that includes the Inspection fee for the uncompleted work. Inspectlon fees do not carry over from one REI to
another.
A service charge of $30 will be added for all dishonored checks.
I hereby certify that I inspected the electrical installation herein on the dates stated: or Department Use Only
Rough - In In pection s Date �� �� I�" L�
/�1(�— �O� �' -- � � .
F�' ral Inspection Date ��p AU G 19 2008
�
�� �-_- i 6 = � 7_c
Thls materlal can be made avallable In dlffererrt torms, such as large pMnt, Brallle or on a tape. To request, call 1-800-342-5354 (DIAL-DLI) Volce or
TDD (651} 297�198.
REI 02 (6/0�