P - 75247/
Minnesota De
443 Lafayette
St. Paul, MN
Phone: (651)
TTY/MRS: 6�
4-17-08
Labor and Industry
1) 297-4198
.state.mn.us
�or Re uest for Electrical Ins
Rough-In Inspection Required?
nuuir»� �i uwNacuuii — auarst
1545 75TH AVE NE
Owner Name
DANIEL BRODIN
Owner Telephone Number(s) -
(763) 784-6976
Contractor Name
HORIZON ELECTRIC
Contractor Telephone Number
(952) 985-8088
tion - One Famil Dwellin /Associ
Yes Single Inspection Other Than Rough-In:
ictions Contractor Must Schedule All Final Ins cti
City/Township County
FRIDLEY ANOKA
Project Description
_ BASEMENT WIRING
ated Structure
❑ Ready Now
ms � Will Schedule
Contractor Mailing Address r n''n '^
21483 GRENADA AVE #180 � l�G �� d l.� 1�✓l ��
Contractor E-mail Address Electrical Utility
m.horizonelectric@frontiernet.net CEL
��9� � CA02188 I MIKE PETERSON
Fee Calculation
New Home or Associated Structure Existing Home/Structure Remodel or Addition
New Dwelling Service/Power Supply 0- 400 ampere @$35 New Service/Power Supply
New Dwelling Service/Power Supply 401 - 800 ampere @$60 New Service/Power Supply
to 30
- More than
Other (Specify)
ts-$100
i to
Each
Detached Garage or Other Associated Structure
New Service/Power Supply 0- 400 ampere @$35
New Feeders/Circuits ( ) @ $6 Each
Other (Specify)
f�:
Reconnected
0 - 400 ampere @ $35
401 - 800 ampere @ $60
� - Up to 15 Feeders/Circuits
$6 Each or 16 to 30 @$100
_ nn�rp Tr,a., an co�orcirs�,.� ��
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
$12
- — - - -- - -
— - --
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 inspecUon trips, $70�.�
whichever is greater) whichever is greater)
Requests for Electrtcal Ins�ction (REI) with a fee of $250 or less expire 12 months from the filing date. The contractor must have the work completed within
the 12 month periad or submk another REI that includes the inspection fee for the uncompleted work. Inspecdon 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 1 inspected the electrical installation herein on the dates stated: ��For Department Use Only
Rough - In Inspection(s) �'� � �� � ��� ��
�° �.
Finallnspection ���
�
This material can be made ava(lable in dtfferen
TDD (651) 287-4198.
REI 02 (6/0�
�-z�'�� I REC'D APR 2�1 20
ch as large print, Braille or on a tape. To request, call 1-
or