P - 75405s
REQUEST FOR ELECTRICAL Ii+iSPEC?ION
� � � � � � � � � � Minnesota E�'�ard of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651)642-0800TTY/MRS 1-800-627-3529 xnvw.edectricity.state.mn.us
Describe -using the baC fof the�'gde copy'rf n�essary - the work covered by this request: �
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Above Zd0 Ampere Q$10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCURS OF LESS THAN 50 VOLTS
Each Addfional Unit @
FaWre
Mue
ONE 8 TWO FAMILY DWELLINGS, EACH UNff
Ineludes the Service and/or Power Suppty up to 500 Amperes, M
Circuits and Twro Inspection Tdps Each Dwelling Unit @$BO
Addfianal Insoection Trios Cc� $ZO
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(minimum total fee is $20) ' �, �J'—
THIS AFtFF FOR WSPECtOR U� OtLLY
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I hsteby certlfy ihat�U�spec�aed the el�isht�� in on the detes stated:
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��� Rough-in Inspectlan Requir�? es ❑ No Insspectlon Other Than Rough-In: ❑ Ready Naw �wtl Call
3 D You must call the inspedorwhen readyl Date Reedy.
I certify that I.am the � LICENSED CONTRACTOR ❑ COMPAIVY ❑ OWNER and hereby requesk inspection of the electricxf wark at
Job Site Street Address � C �
Tovmship on Rartge Flre No. nty
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idor U ense Number Master Ei�tric(an oc Power LImiG
Ll�nae Number
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PI Provide Two (2) Phorre umbers IrtGudtr�g A
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