P - 80477�,+ REQUEST FOR ELECTRICAL INSPECTION �.
Minnesota Board of Electricity �
' 1-381-450 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 ' �
� (651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. sta te. mn. us
IIdentity the work covered by this request:
QIVEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERALFEES
401 to 800
C
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNI'n
3 to 12 Units �$50 Per Unit
XCEL Eh1ERGY �AYER'S SWITCH
Outdoor Liahtinq Standard � $1
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 and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit (� $SO
Additional Insoection Trios � $20
PoP INSPECTOF USE ON�V
ROUGH IN
FINAL INSPECTION
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total fee is
DATE
DRTE
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- FOR OFFICE USE ONLY
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Reques�t $Dat�� Rough-in Inspectlo� Required? ❑ Yes ❑ No Inspection Other Than Rough-in: ❑ Ready Now ❑�II Call
You must call the inspector when ready! Date Ready:
I ce�ify that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical wodc at:
Job Address (Street, Box, or Route No.) City Zip Code
1391 CREEK PARK LM FRIDLEY 55432
Section Township Range Fire No. County
ANaltA
Occupant -R � [1 Fl ..d n ; Phone
THC�MAS RICHAR[i S
tiivi� �
Power Supplier Address
XCEL ENERGY
Elecfical Contractor 1 Company Name Contredor License Nurr�er Master L�ense Number
HUNT ELECTRIC CORP4RATION CA 00883
Mailing Address (Contractor, Company or Owner Performing Installation)
2300 TERRITURIAL ROAD , SAINT PAUI� MN 55114
Authorized Signature (Contractor, Company or Owner Perfortning Installation) Phone
�1 8�'�11
EB-OOOOtA-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY