P - 75384��o ��
, Minnesota Depa ent of Labor and Industry
443 Lafayette d North
St. Paul, MN 155-4342
Phone: (65 284-5064
T1Y/MRS� 651) 297-4198
www.ele citv.state.mn.us
Con�ractor Re uest for Electrical Ins
Date Rough-In Inspection Required?
08/14/2008 Contractor Must Schedule All Rou h-In
Address of lnspection — Street
6831 7TH ST NE
Ovmer Name
JOYCEJOHNSON
Owner Telephone Number(s) — Include Area Code(s)
(763) 572-8948
tion — One Family Dwelling/Assc
Yes Single Inspection Other Than Rough-In:
CitylTownship County
FRIDLEY ANOKA
Project Description
WIRE/ RECONNECT FURNACE
ated Structure
❑ Ready Now
ms n 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
CA01796
Fee Calculation
or Associated Structure
New Dwelling Service/Power Supply O�U e e@$35
New Dwelling Service/Power Supply 401 — 800 ampere @$60
New Dwellina Feeders/�ts � -�
Home — More than 30
Other (Specify)
JCID/I�IIIiYII� �
(in addition to
Detached Garage or Other Associated Structure
New Service/Power Supply 0— 400 ampere @$35
New Feeders/Circuits ( ) @ $6 Each
Other
Job/ProJect Gontact Person
JOANN ZINKEN
Existing Home/Structure Remodel or Additlon
New Service/Powrer Supply 0— 400 ampere @$35
New Senrice/Power Supply 401 — 800 ampere @$60
New/�xtended Feetlers/Ci�cuits-'tTp to 15Feeders/Ci�cuits
Feeders/Circuits $6 Each or 16 to 30 $100
Alow/Fx4cnriori Gaorllarc/(:irri iitc — Mnra Than �(1 Fwarlarc/C:irr� �i4c
200 A [a� $6 Each
Detached Garage or Other Assoclated Structure
New Service/Power Supply 0— 400 ampere @$35
New/Extended Feeders/Circuits ( ) @ $6 Each
Reconnected Feeders/Circuits ( ) @ $2 Each
�2
Total (the fee calculated above or $35 multiplied Total (the fee calculated above or $35 multiplied Sd
by the number of required inspection trips, by the number of required inspection trips, 3�`
whichever is greater) whichever is greater)
Requests for Electrlcal InspecUon (REI) w(th a fee of $250 or less expire 12 months from the filing date. The contractor must have the work completed withln
the 72 month perlod or submk another REI that Includes the lnspectlon fee for the uncompleted work Inspectlon fees do not carry over from one REI to
another.
A service charge of $30 will be added for all dishonored checks.
I nereby certrty tnat I Inspected tne electncal InstallaUOn nerein on tne aates statea:
Rough — In Inspection(s) Date
Final
i .,✓v l r ` �-
This materlal can be made available In dlfferent forms, such as
TDD (651) 297-4198.
REI 02 (6/07)
������ �� � �
REC'D A U G 18 2006
n a taae. To request, call 1-800-34
or