P - 80048w
' REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
r 1-393-756 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 —
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity.state.mn. us ' '
Identify the work covered by this request:
U'11EW ❑ REMODEL ❑ ADDITION ❑ REPAIR
to 800
�
0 to 200 Am ere (� $5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGI
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or Ap aratus �$.50
ADDITIONS TO THE GENERAL FEES
3 to 12 Units
Lighting Retrofit � $25 per Fixture
Center Pivot Irrigation Boom (� $4C
Manufaciured Home Park Lots � $
Recreational Vehicle Park Sites �
Separate Bondinp Inspection � $2i
XCEL ENEROY SAVER'S SWITCH
Outdoor Liqh[inq Standard � $1
to 10
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Sernce andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unft �$80
Additional Insoection Trips � $20
FOp INSGECTOF LLSE ONLY
�•
I hereby certity Mat I
ROUGH IN'
TOTAL FEE
total fee is $20)
DATE
DATE
� �
FOR OFFlCE USE ONLY
IIIIIIIINNI{IIIIIIIININIINIiI{{I��I� ��sy
* 1 3937560'` �p�3—�
Reque��� Rough-in Inspeefion Required? ❑ Yes C�No Inspection Olher Than Hough-in: �Ready Now ❑ Will Call
You must call the inspector when ready! Date Ready:
I certi(y that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
,bn nda�e� �,��c, so���i1%�A� �� FRIDLEY �P�32
Section Township Rang� ^ i�� County A��a
!%
Occupant ' Phone
AMERICAN TiRE 8 AUTO
Power Supplier Address
xec� En�oi
Electrical Contrador / Company Name Contractor License Number Master License Number
HUNI' ELECTRIC GORPORATION GA 00883
Mailing A� Contractor,�CompaLyli�AO , PSAIN18PAe1t�, �M� N 56114
A
AutFwrized ' nature (� racto� r,� r Owner Performing Installation) Phone
�t1 �-2911
EB-00001A-13 7/1/2000 BOARO OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY