P - 80482•�
- REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
` 1-381-446 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 �,`
(651) 642-0800 TiY/MRS 1-800-627-3529
www. electriciry. sta te. mn. us
Identify the work covered by this request:
IlICEW ❑ REMODEL ❑ ADDITION ❑ REPAIR XCEL ENERGY �AVER'S SWITGH
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traific Si nal Standard �$5
0 to 400 Am ere �$25 Su lemental Fee �$20
401 to 800 Am�ere � S50 Transfortners u� to 10 KVA ��10
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus � 5.50
ADDITIONS TO THE
TIFAMILY DWELLINGS (PER UN
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
F�Rure
� $40
�
�
Transfortners over 10 KVA � $20
Transformers / Power Supply for Signs I Outline Lighting �$
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Servrce arM/or Power Supply up to 500 Amperes, All
Circuiis and Two Inspection Trips Each Dwelling Unit �$80
TOTAL FEE
total fee is $201
FOF INSPECTOF USE ONLV
I hereby certiy that f inspected the electncel installation descnbed herein on the detea s�etetl:
ROUCaHIN DRTE
FINALINSPECTION DATE
/l 26-a(
FOR OFFlCE USE ONLY
I I�III IIIII �III 11111 IIIII �lll IIIII 1� � IMl �l
* 1 381 4462'` �����"�`�
Request Date: Rough-in Inspectlon Required? ❑ Yes ❑ No Inspection Other Than Rough-in: ❑ Ready Now ❑ Will Call
�g�8ro1 You must call the inspector when readyl Date Ready:
I certi(y that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
6560 ARTHUR ST NE FRIDLEY 55432
Section Township Range Fre No. County
ANfiKA
Occupant Phone
KaSSAN DENNIS N ti � � � �
Power Supplier Address
XCEL ENERGY
Electrical Contractor / Company Name Contrectoi License Number Master License Number
HUNT ELECTRIC �4RPORATI4N CA Q0683
Mailing Address (Contractor, Company or Owner Performing Installation)
230Q TERRIT�RIAL ROAQ , SAINT PAUL, MN 55114
Authorized Signature (Contractor, Company or Owner Perfortning Installation) Phone
861 848-291i
EB-OOOOtA-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY