P - 75411Minnesota Departrn ht of Labor and Industry
443 Lafayette Roa�North �
St. Paul, MN 55,�� 5-4342
Phone: (651) 2 5064 `1�5
TTY/MRS: ( ) 297-4198 Cw
www.electri .state.mn.us
Cont ctor Re uest for Electrical I
Date Rough-In Inspection Required?
11 /06/2008 Contractor IVlust Schedule All Rou I
Address of Inspection — Street
6801 7TH STREET NE
Owner Name
JEAN SAXTON
Owner Telephone Number(s) — Include Area Code(s)
(763) 571-3297
:tion — One Famil Dwellin /A:
Yes Single Inspection Other Than Rougt
actions Contractor Must Schedule All Final I
City/Township County
FRIDLEY ANOKA
Project Description
WIRE/ RECONNECT FURNACE AND AIR
CONDITIONER.
Structure
] Ready Now
� Will Schedule
Contractor Name : Contractor Mailing Address
CENTERPOINT ENERGY 9320 EVERGREEN BLVD NW SUITE B COON RAPIDS, MN 55433
Contractor Telephone Number , Contractor E-mail Address Electrical Utility
(763) 757-6202 joann.zinken@CenterPointEnergy
Contractor Authorized Signature Contractor License Number Job/Project Contact Person
CA01796 JOANN ZINKEN
Fee Calculation
ewr Home or Associated Structure
New Dwellinq Service/Power u 400 ampere @$35
Existing Home/Structure Remodel or Addition
New Service/Power Supply 0— 400 ampere @$35
New Dwelling Service/Power Supply 401 - 800 ampere @$60 I I New Service/Power Supply
Up to 30 Feeders/Circuits - $'
— More than 30 Feeders/Circuits (in addition to
1 Feeders/Circuits Ua To 200 A L$6 Each
Detached Garage or Other Associated Structure
New Service/Power Supply 0— 400 ampere @$35
New Feeders/Circuits ( ) @ $6 Each
(Specify)
401 — 800 ampere @ $60
� — Up to 95 Feeclers7Circuits
$6 Each or 16 to 30 @$100
— More Than 30 Feeders/Circui
ts Uo to 200 A CD $6 Each
Reconnected Feeders/Circuits
( 2 ) Feeders/Circuits @ $2 Each $4
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
Other (Specii�r)
Total (the fee calculated above or $35 multiplied Totel (the fee calculated above or $35 multiplied �d
by the number of required inspection trips, by the number of required inspection trips, �,3�j •
whichever is greater) whichever is greater)
Requests for Electrical InspecUon (REI) with a fee of $250 or less expire 12 months from the flling date. The contractor must have the work completed within
the 12 month period or submit another REI that includes the inspectlon fee for the uncompleted work. Inspection fees do not carry over from one REI to
another.
A service charge of $30 wlll be added for all dishonored checics.
I hereby certify that I inspaded the electrical instaliation herein on the dates stated: Fo� Department Use Only
Rough — In Inspection(s) Date ��� � r� �/,'
���
Fina� �ncnar.tio � _.. i Dat�� ; 1�L� NOU � o�OOU
j����- � ����� � �r
This mateM can be made avallable in d erent forms, such as large print, Bratlle or on a tape. To request, call 7-800-342-5354 (DIAL DLI) Voice or
TDD. (651) 297-4198.
REI 02 (610'n ,