P - 80475. REQUEST FOR ELECTRICAL INSPECTION
• Minnesota Board of Electricity
�� 1-351-451 '� 1821 University Avenue Suite S-12s, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-500-627-3529
www. elect�iciry.state.mn. us
Identify tfie work covered by this request:
LfItlEW ❑ REMODEL ❑ ADDITION ❑ REPAIR XCEL ENERGY �AVER�3" �WITGH
GENERAL FEES Outdoor Liphtlnq Standard �$1
to 400 Ai
)1 to 800
�ove 800
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALWG
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
rIFAM�LY DWELLINGS (PER
3 to 12 Units �$50 Per Unit
Each Additional Unit � �25
Home
�+a
,� �,�'
, ��:
� ranstormers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformers 1 Power Suoolv fa Sians / Outline Liohtino (� R5
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 �$80
Additional Inspection Trips � $20
Investigative Fee
Reinspection Fee � $20
TOTAL FEE
(minimum total fee is $20)
FOfl INSPECTOP USE ONIY
I hereby ceRity �hat I inspected the electrical installatiar
FOUGIi IN
FINAL INSPECTION _
DATE
OATE
��� L
FOR OFFICE USE ONLY
I�I�����������(�����II��I�INI�I�I��lnl ���� -
* 1 381 451 2* '��
Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than Rough-in: ❑ Ready Now ❑ Will Call
(f9128101 You must call the inspector when ready! Date Ready:
I certi(y that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
Job Address (Street, 8ox, or Route No.) City Zip Code
160 CRGWN RD NE FRIDLEY 55421
Section Township Fange Fire No. Counly
At+IUKA
Occupant 6�. f; Phone
JESSER OREC3�RY M '� �7 �
Power Supplier Address -
XCEL ENERGY
Electrical CoMractor / Company Name Contractor License Number Master License Nurtiber
HUNT ELE�TRIC CORPORATION CA 00883
Mailing Address (Contractor, Company or Owner Performing Installation)
2�00 TERRtTOR1AL ROAD , SAINT PAUL, MN 5�1 t4
Authorized Signature (Contracta, Company or Owner Performing Installation) Phone
EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY