Loading...
P - 77745' � REQUEST FOR ELECTRICAL INSPECTION 1��� J- 3 5 5 9� Minnesota Board of Electricity 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 (651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.slate.mn.us Describe -using the back of the white copy if necessary - the work covered by this request: EXCE� EhiE�GY SAVEF.`S SWITGH GENERAL FEES Outdoor Lighting Standard @$1 SERVICES / POWER SUPPLIES Traffc Siqnal Standard (� $5 Above 800 Am ere $75 � CIRCUITS I FEEDERS 0 to 200 Am ere $5 Above 200 Am ere $10 ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Each S stem Device or Apparatus @$.50 ADDITIONS TO THE GENERAL FEES MULTIFAMILY DWELLINGS PER UNIT 3 to 12 Units @$50 Per Unit Each Additional Unit lc� $25 Irrigation Boom C I Home Park Lots Vehicle Park Site: THIS INSTALLATION MAY BE ORDERED II� I� III II I�� II I� II (II I) III �I III (I (II II III I III) 17?53559 ; -,�. �: � �,���. = `,.,�_ Transfortners u to 10 KVA $10 Transformers over 10 KVA $ 20 Transformer! Power Su I for Si ns I Outline Li htin $5 ONE & TWO FAMILY DWELLINGS, EACH UNIT Indudes the Service and/or Power Supply up to 500 Amperes, All Circuits and Two Inspection Trips Each Dwelling Unit @$80 Additional Ins ection Tri s $20 Investigative Fee Reinspection Fee $20 TOTAL FEE (minimum total fee is $20) THiSAREAFORINSPECTORUSEONLY L tl` I hereby certify that I inspected ihe electrical installation described herein on the dates slated: 1-/fr'oS � D IF NOT COMPLETED WITHIN_12 o`Z�OS- (�CSO ad � � vaie: ! Rough-in Inspection Required? ❑ Yes Q No ��� Inspection Other Than Rough-In: � Ready Now ❑ Will Call �'� i������5 You must call the inspector when ready! � Date Ready: I certify that I am the [X7 LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at - - -- �, Job Site Street Address �� � - � - �� � �a� �VE ME Section ; Owner/Occu ant Name _ _-- --- - P Please Provid� � WHALEY Sr�T7 F � ) I Electrical Utility Electrical Utility Address � XCEL EhIEF;CiY - --- I IContrector / Company Name Contractor License Number ' HUhiT ELECTf,IC GOf:F'UhATI0�4 CA t?�}883 �_- _—_ -. . _. ___ ' Mailing Address (Contractor, Company or Owner Performing Installation) �304 TEhf�:ITOfiTAL FtOAD, SAIhET F'AUL, MN 5513.� F�,IDLEY iry AMOKA Phone Numbers Including � ) Master tlectncian or License Number Authonzed Signature (Contractor or Owner Performmg Installation) ' Please Provide Two (2) Phone Numbers � %� (�51) b46-�911 ( � INSTRUC710NS ON BACK OF YELLOW COPY BoARn oF Fi FcTRiciTV cncv