P - 76752FROM :City oF Fridley
;.+�Mr..��:;s .^.«pa M pf abar and li�dustry
��3 Lafayette R d North
St Peul, �JIN . 55-4342
Phone, (B51) 4-5064
T�YIMRS: ( 1) 297'-41
wv�w.ekctri .state.mn. s
Homeowner
� Dat� � Roug In Inspeclion Repulred"t
l� f d 9r �� Nom er Must Schaduk All R<
Addrc�ss of Inapection - trs�t
� �° � /�A- ,�-'` � '4 � `e� _
f�umPr Narite �
v.�� "a.,d�-t i �-�
Owner TekphonG Numb f(� - InClu Area Code(s
7��— �7 l��i�l�iR
Ownar Mailinp
c� a�c
Qrr�gr �-mail,
R �� /'► /-1 v �
FAX N0. :7635711287 Nov. 26 2007 06:38PM P2
RE81DENtIAL E1.ECTRICAL PERMIT BY HOM�OWNER
PERt�i� # ��� 1 ���� ��
RECEIVED: _
uest for Electrica{ Ins�ec�±o�n ,. .^
Y� Inepection Ort�er Than Rough-In; � Ready Now.
'----.:--� �.......�....s���..�s a,.�,�..te en �,..I InReectiens n V1j1! SChBdule
/�/i ( � C�� � � M �I-n! o ��4- _ _ .
Pr�jecf Dtsuiptbn . '
.�: � ��• S'�/� (i r C 2.
c,'�� j r., t,� •.' r J ' ,.:.-"C, , .
� -w a.va .�►^��s, s�cl�.��.� �t, ���
L c n�`� �S
iF� � `d�c,�Y
�rica� uU�tr
� `�f /
.�iG►C L�N �.wc
�inr ��f � L
9y signing thi! documa , i Celtify ttlgt I�1i tt1e DWI'1�f a6 G@11f190 oy Mtil�. �ta� g�m.vi anu wo� rogaoy N�i ��n��� u�o o�u�.�� w��n
±4*ll'IE� S(4^@fl!!'9 ' • •
G� L- � - . , .
Fee Ca{culation
New Ho e or Aszacfated Struch�re Existing HomelStructu�e Remndel or Addiiion
N�w Home Service/Po r 5uppy 0- 4oD ampere � S35 New Servioe/Pwvar Supply� ,r� L� � � 4D0 ampere � i35 �( _�
� ��
N�wv Home Servlte/P r Suppy ao1 �- 800 ampars (� S6U New Sr.rvk�,IPawer Supp►y 401 - s00 ampere � SGO �
Naw H� ome�oede�sJC its -- -- -� --- Ntw FeedetalCireuib - Up to 15���i�s%�� � Y 2 �%
� UP to 30 Feeda►s/CUcvits • 5100 ..(_j,Fesders/C'rcul�t Q f6 Each or 1G 1a 30 (� 5100
New Home - Mare tt►an Feeders/Circulb (in addldon to 1Jow FeederstCUcuits - I�+I�on Than 30 FeederslCi�euits
abovel l 1 Feede Ireuits Up To 200 A� SG Eqoh . f 1 PeederslCrcuits Up to 2D0 A�_�6 Each _ ���Jz"
Qek�ched G;
NCw ServiceJPowe� S
New Fes�rs/Circuka
Othar (Sf+ecitYj
or Other AssociatEd Structure
0 - 400 empere � S35
( ) � b6 Esch
( ),Feod�rslCirauits @ S2 Each _
aotached Garage or Other Assoctated 5tructure
New 5ervlcelPower Supply 4- ab0 ampere �i; 515
Nevr Feeders/Grcufta ( ) � s6 �gGi
Reoonneeted FeecferrJClrcuits ( ) (� S2 Esch
�
TOtat (tAe tr.e calcu�at above or S35 rn��ldpl'rod 7ot81(the fee calculated sbove or y35 multi�?iiPd
by the numbmr of requly d insper,tb� tr'�ps, . by the number of rcqu'red 'msper,llon t�ips,
rwhlthever ia gr�ater) _ .,, ^_ whichever k preaiPr) ._ . _ Y._
�eq�!. +.,r F;r..cfrksl !(bp4v:tlon (R.plj witfi � tae o( S�Sn or le=i eRpirr 1Y monC�s from the filinp dAte. The owno� rrlir.y hrwe the work compl�ted whhln f1r_
t Z!�;unth ,_ iu� ^� subr�it anoEliet RF) thef IncluMnfe Rhe lnspatUOn fee tor the N��mplotCd work Ihspccllon iees do nol CBrry ovrr from ane Rtl to another.
q se���IG� ChAC9� of �:ri �di us adECd for all tliC�w.I,s .�d ct;:�k5. _ ,
I hw�by co thAt 1 Ins +� ed the dechiml inslapntlon heroln on R+s dst�s sU�tcd: " .. Fw Dopwrtma+t Uoa Only
Rouph - In Inspeotion s)' �/� I�-2�.. c? Dato c'/ 'C/� �; U
b /'
►��l� - � � � /i�,�'♦I�- ��► .,�
F�nalln�pectian O te
����
71�1� rtuterial Fet� m do AvsSlablo In diH�rant foems, such S la�Qe prittt, Braflle o��On a tapa. To �eques� catl 1-0DD.Z42-SSr}� (PIpL-OLIj Vo�r,q or
'1'pb (651) 297•41D8. '
�zr_i o� �sro�>