P - 80037''� REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board ofi Electricity
1-396-1 14 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. elect�iciry, sta te. mn. us
IIdentity the work covered by this request:
�I�EW ❑ REMODEL ❑ ADDITION ❑ REPAIR
AIARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or Ap aratus �$.50
ADDITIONS TO THE GENERAL FEES
Unit � $25
OTHER ADDITIONAL FEES
� $25 per Fixture
�ation Boom � $40
XCEL ENERQY SAVER'S SWITCH
Transformers u to 10 KVA �$10
Transfortners over 10 KVA � $20
Transfortners / Power Supply for Signs / Outline LigMing �$;
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Indudes the Service andlor Power Suppiy up to 500 Amperes, AII
Circuits and Two Inspection Trips Each Dwelling Unit �$80
Additional Insoection Trios � $20
TOTAL FEE
total fee is $20)
nnanutactured home Nanc �ots �$z5 I hereby certfij ihat I inspected the electrical inslallation describetl herein on the tlates stated:
Recreatio�al Vehide Park Sites �$5 RWGH IN OATE
Se arate Bondin Ins 'on � $20
Special Ins ection �$30 f HOUf FINAL INSPECTION DA
S ecial Ins ection �$.31 er Mile ��
_ _'�jIS NST LLATIQ��Y_�E_QAR�REQJ�J,�t.�QNNECTED��IQISr��l�PLETED�(yJ�HIN1$MQNTHS _
FOR OFFICE USE ONLY
( IIIIII I�I �III IIIII II��I �II I�I � � ��I ��
* 1 3961 1 49* �'�SO
Reque��� Rough-in Inspection Required? ❑Yes C�No Inspectlon Other Than Rough-in: �Ready Now ❑�II Call
You must call the inspector whBn ready! Date Ready:
I certify that I am the L�S LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
Job Address (�tr,@gt, Bo��iqut@�� City FRIDLEY Z'p �B �32
;�tJ(1 ! 1 fi A
Section Township Range Fire No. County a�a
Occupant Phone
�'�1� i �i�l� � i►
Power Supplier Address
XCEL ENEF�GY
Elechical Contraaw ! Com ny Name Cornractor License Number Master License Number
HUNT ELEC�RI6 CORPORATION CA 00883
Mailing Address LContractor, Com ny or Owner Performin Installation)
2300 TEF�RITOF2iJ�,1.. R�7A0 , SAIN'iQPAUI, MN 55114
Authorized Si naWre (�ract�w, Com�pany or Owner Performing Installation) Phone
i�F �-?� e�z�ii
E&00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY