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P - 75582Minnesota De 443 Lafayette St. Paul, MN Phone: (651) TTY/MRS: (6 3nt of Labor and Industry North 297-4198 Contrac�or Re uest for Electrical I Date Rough-In Inspection Required? 8/22/08 Contractor Must Schedule All Rou I Address of Inspection — Street 7541 ABLE ST NE HARRY VERNER Owner Telephone Number(s) — I (763) 413-8192 Contractor Name DYMANYK ELECTRIC Contractor Telephone Number (612) 379-4112 Contractor Authorized Signature :tion — One Famil � Dwellin Yes Single Inspection Other Than City/Township County FRIDLEY ANOKA Project Descriptlon WIRE OUTLET FOR SUMP PUMP Contractor Mailing Address 1915 NE BROADWAY eldon@dymanykelectric.com Contractor License Number CA00554 Fee Calculation New Home or Associated Structure New Dwelling Service/Power Supply 0— 400 ampere @$35 New Dwelling Service/Power Supply 401— 800 ampere @$60 fVew Gweiting FeederslCircufts - r rovurn�vncu�w - y cuits (in addition to To 200 A (�a. $6 Each Detached Garage or Other Associated Structure New Service/Power Supply 0— 400 ampere @$35 New Feeders/Circuits ( ) @ $6 Each ElecVical Utllity KCEL Job/Project Contact Person ELDON HOLMES Structure � Ready Now � Will Schedule Exlsting HomelStructure Remodel or Addltion New Service/Power Supply 0— 400 ampere @$35 New Service/Power Supply 401— 800 ampere @$60 IVewiExtended Fe�ders/eircuits — Up to 15 Feeders/Gircvits I ( 1 ) Feeders/Circuits aCi $6 Each or 16 to 30 @$100 New/Eutended Feeders/Cfrcuits — Mere Than 30 Fwwdwrc/Cirndtc to 200 A Ca� $6 Each ( ) Feeders/Circuits @,i $2 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 Other (Soecifii) � Totel (the fee calculated above or $35 multlplied Totel (the fee calculated above or $35 mul�plied by the number of required inspection trips, by the number of required inspecUon Mps, whichever is greater) whichever is greater) $35 •� Requests tor ElecMcel Inspecdon (REI) with a fee of $250 or less �xpire 12 months irom the flling dat�. The contractor must heve the work completed wfthl�, the 12 moMh peHod or submlt another REI thet includes the inspectlon tee for the uncompleted work. Inspection fees do not c�rry over from one REI to '� �� another. • �,?� � ��� �, y� Z_,� � A service charge ot $30 will be added for all diahonored checka. I hereby certfiy that I inspected the electrical installatlon herein on the dates stated: G For Depardnent Use Only Rough — In Inspection(s) Date This matenal can be made TDD (651) 297-4198. REI 02 (6/07) � � � `� �.� /�I � Date � -rr - ��' REC'D AUG 2'� 200� �uch as large print, Braille or o a tape. To request, call 1-800-342-535 or