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P - 80032REQUEST FOR ELECTRICAL INSPECTION Minnesota Board of Electricity � 1-396-122 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 — (651) 642-0800 TTY/MRS 1-800-627-3529 www. electricity.state.mn. us IdentiTy the work covered by this request: O,10EW ❑ REMODEL ❑ ADDITION ❑ REPAIR to ALARM, GOMMUNICATION, REMOTE CONTROL, SIGNALING CIRCUITS. CIRCUITS OF LESS THAN 5Q VOLTS Each System Device or aratus �$.50 ADDITIONS TO THE GENERAL FEES MULTIFAMILY DWELLINGS (PER UNI 3 to 12 Units �$50 Per Unit Each Additional Unit � $25 OTHER ADDITIONAL FEES Li dn Retrofit �$25 er Fxture Cer�ter Pivot Irri ation Boom �$40 Manufactured Home Park Lots � $25 Recreational Vehicle Park Sites � $5 Se arate Bondin Ins ction �$20 S ial Ins 'on �$30 er Hour Special InSpection � $.31 per Mile Transfortners u to 10 KVA �$10 Transfortners over 10 KVA � $20 Transfortners / Power Supply for Signs / Outline Lighting �$! ONE & TWO FAMILY DWELLINGS, EACH UNIT Includes the Service andlor Power Supply up to 500 Amperes, Ail Circuits and Two Inspection Trips Each Dwelling Unit �$80 Additional Inspection Trips � $20 FOF INSPECTOR USE ONLV FINRL FOR OFFICE USE ONLY TOTAL FEE total fee is $20) oare DATE ,� 3.. G� IIIIIIIIII811NIIIIIIINIINI{i{4111�1�1�1 �s� *13961222* �� Request Date: Rough-in Inspectlon Required? ❑ Yes ❑ No Inspection O[her Than Rough-in: ❑ Ready Now ❑ WfN CaN 08l18/02 You must call the inspector when readyl X Date Ready: x I certi(y that I am the F� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: dab Address (Street, Box, ar Houte No.) Ci1y Z+p Code 7488 BAC�1 DR NE FRIDLEY 5&432 Seclfon Township Rang2 9 Fire No. County �� Occupant Phone b'�A JEREMY JAMES Power Supplier Address �. �Y Electrical CoMrador / Company Name Contractor License Number Master License Number HUNT ELEGTRlG 04RPORATIQN CA 00883 Mailing Address (Contractor, Company or Owner Performing Installation) 2300 TERiiITCKtiAL {3�AD , SAINT PAUL, MN 55114 Authorized Signature (Contrector, Company or Owner Pertortning Installation) Phone �51 6�fi-2911 EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY