P - 80010REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
` 1-396-139 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electriciry.state.mn.us ' �
Identify the work covered by this request:
❑�IEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
to
0
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRGUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or A paratus �$.50
ADDITIONS TO THE GENERAL FEES
3 to 12 Units �$50 Per
Each Additional Unit � 9
XCEL ENEROY SAVER'S uWITCH
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transfortners / Power Supply for Signs / Outline Lighting �$5
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 l� $20
Investi ative Fee
Reinspection Fee � S20
TOTAL FEE
(minimum total fee is $20)
FOP INSPECTOF USE ONLY
1 hereby <
ROUGM IN
me e�ea�cai Ms�snaeon aescrieed ne�am on ure as�es s��ea:
DATE
� Q DATE
�t � /trzf a�.
FOR OFFlCE USE ONLY
I III��I �III III�� �IIII �I��I �� III�I IIIII �II III) ���
* 1 3961 396* ��-d
Reque�t �� Rough-in inspection Required? ❑ Yes C�No InspecHon Other Than Rough-in: G�Ready Now ❑ Will Calf
You must call tFie inspector when ready! Daie Ready:
I certiiy that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
Job Address{0��{t1 B� HA�MANN GIR NE �� FRiDLEY Z�P �e �J
Section Township � �ge� � Fire No. Counry ���a
� �
Occupant Phone
Ha..oa�MSOrv sH�atFrr a
Power Supplier Address
XCEL EN�Y
Electrical Contractor ! Company Name Contracior License Number Master License Number
HUNT ELEGTRIC CORRORA710W CA OQ883
Mailing Address Contractar, Company or Owner Pertarmin Installatio�)
2300 �TORIAL Rt?Ab , SAINI�PAUL, MN 55114
Authorized Si� (C�ractop r,� r Owner Performing Installation) Phone
8.51 646-2Q11
EB-00007A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY