P - 76337�p �j REQUEST FOR ELECTRICAL INSPECTION / ;
���1 �a.� 3 7 0 � Minnesota Board of Electricity �/
1821 University Avenue Suite &128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-600-627-3529 www.eleetricity.state.mn.us
Describe -using the back of the whfte copy If necessary - the work covered by this request: S.�—� v/ C�
Gr IQ �� / c E: �?G l�1�-A� �/Z n co
GENERAL FEES Outdoor Liahtina St�arMward (�a. $1
0 to 400
ALARM, COMMUNICATION, REMOTE CONTROL
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aoaaratus a(�. $.50
Each Addfional Unit @
Retrofit
I�u I� ul �I ul � lu II III �� II) II II� II O) � W��
21233705
up to 10 KVA @ $10
wer 10 KVA C�D $ 20
Includes the Servfce and/ar Power Supply up to 500 Amperas, All
Circui4s and Two Inspection Trips Each Dwelling Unit (� $80
(minimum tatal fee is $20) �
nus t�a wa uarECroa tse oear
I hereby cettHy that I Ins�ded the elecLical InatellaUon desa@ec
ao� w
Fuua�ovsr�cnoN �
1
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ECTED IF NOT COMPLETED WITHIN 1;
POR OFPICE USE OMLY
REC'D MAY - 7 2001
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�� Raugh-in Inspacdon Requir�? ❑Yes °�No IrrepecUon Otl�er Than Rough-In:�Ready Naw ❑WN Ca0
""��� You must call tlie inspector when readyl Da[e Ready.
f c�rtify that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OYYUNER and hereby request msp�ion of the el�trical work at
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Addreas
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�� o� P�e �� Sprinte� Electrical Services CA03969 AA100878
2525 Nevada Ave N#203, Golden Valley MN 55427
nmer Performing Installatloc ph011@ 763-546-8060 FeX 763-546$084