P - 82191REQUEST FOR ELECTRICAL INSPECTION �"°°`'
, � —O � � —��� � Minnesota State Board of Electricity � _ -
y 1821 University Avenue Suite S-12$ Saint Paul, Minnesota 55104-2993 =_
(651) 642-0800 www.e/ectricity.state.mn.us
Home Duplex Apt.8ldg. Other: New Adtln
Commercial Industrial Farm Remod Repair
Air Conditioner Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elect. Heat Temp. Service
'X" above the work covered by this request. Enter remarks in this space and on the back of the white copy on/y.
NSP SAVER'S SW{TCH
Calcu/ate Inspection Fee - This lnsnection Reauest will not be accepted without the correct fee.
Mobile Home Park Stall
Street Ltg. / Traffic Sig.
Transformer/Generator
Sign / Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming Pooi
� Service Entrance Size Fee # Circuits / Feeders F
0 to 200 Amps 0 to 100 Amps
Above 200 Amps Above 100 Amps
INSPECTOR'S USE ONLY TO��,
I hereb certify that I inspected the electrical installation described herein on the dates
Reuah In D8te
Investigative Fee � � I �G[ —/ ? � �' �
THIS INSTALLATION MAY BE ORDERED NECTED IF NOT COMPLETED WITHIN 18 MONTFIS.
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I I�I�II I�III IIIII I�I�) II��� II�I �I I�1' ��) OFFICE U8E ONLY This requsat void 18 rtronths from validation date priMed in this box.
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* 1 0 1 1 4 s* � �:�.��
PLEASE PRINT OR TY
Request Date Rough-In inspection required? ❑ Yes ❑ No Inspection Other Than Rough-I�: ❑ Ready Now ❑ Will Call
�2��� You must call the inspector when ready! Date Ready:
I, � licensed contractor ❑ company ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No. City Zp Code:
?4? CHR�S'1'ENS4N CT NE FRIDI.EY 5643'2
Section No. Township Name or No. Range No. Fire No�-----� County� u��
_.__--- -... _._ _ - !•U�
Occupant ��NKiNS DEL D Phone No. »,^_
Power $yQpJ�er Address
N�P ------------
Electrical Contractor / Company Name Contrador License No. Master Lic. No. (Plant Eled. Only)
HUNT ELECTRIC CGRPGRATIGN CA 00883
Mailing Address (Contractor, Company or Owner Perfortning Installation)
2300 TERRRK3RIAL ROAD , SAINT PAUL, MN 55114
Authorized Signature (Contractor, Company or Owner Perfarming Ins a' n) Phone Number
�la�ra ( ��D �as-2s�,
�B-OOOOtA-12 5/1999 STATE BOARD COPY SEE INSTRUCTIONS ON BACK OF YEILOW COPY