P - 81679REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity �
1� O� 1� 7 7 9 °tl�4��°. 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TiY/MRS 1-800-627-3529
• www. electricity. state. mrz. us
IdentiTy the work covered by this request: �� /:
l/
❑NEW OREMODEL ❑ADDITION ❑REPAIR 60 Amp Feeder, range, microwave, ara e
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am ere �$25 Su lemental Fee �$20
401 to 600 Am re �$50 Transformers u to 10 KVA �$10
Above 800 Am re �$75 Transfortners over 10 KVA �$20
CIRCUITS / FEEDERS Transiormer I Power Su I for Si ns / Outline Li htin �$5
0 to 200 Am ere �$5 ONE & TWO FAMILY DWELLWGS, EACH UNIT
Above 200 Am re �$10 Includes the Service and/or Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwellin Unit �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ection Tri s�$20
Each S stem Device or A ratus �$.50 Investi tive Fee
ADDITIONS TO THE GENERAL FEES Reinsaection Fee �$20
2 Units � $50 Per Uni2
Additional Unit � $25
OTHER ADDITIONAL
ia Retrofd � $25 oer Fature
total fee is $20) I 24.
INSPEGTOH USE ONLY
I hereby certiN Mat I inspected the elecGical insfalla6on desciibed herein ai the daks
aecreational Vehicie Pa�k Sites � $5 " "01GX1X
5e arate Borniin Ins 'on � $20
3 ecial In ion �$30 er Hour �"�"0N
3 ecial Ins �on �$.31 r Mile
THIS INSTALLATION MAY BE ORDERED DISCONNECTE
FOR OFRCE USE ONLY
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I ce�ify that t am the � LICENSED CONTRACTOR [,.COMPANY ❑ OWNER and hereby request inspection of the electrical work at
Job Address (Street, Box, or Route No.) Cit�r Tap Code
142 71 1/2 Way Fridley 55432
Occupant
Ryan Meli�ille
763-502-0703
Power Supplier � ^� Address
V
Electrical Contractor / Company Name ConVector license N
Total Electric, Inc CAO 2749
Mailing Address (Contractor, Company or Owner Performing Installation)
1076 nkato St NE B1 ' e, MN 55449
Authorized a ture (Contraator, oan Owner in Ilationl �.
f/U�/v"�(/ •� " V L/ � 763-786-8484 �
7/1/2000 � BOARD OF ELEC7AICRY COPY INSTAUCTIONS ON BACK OF YELLOW COPY