Loading...
P - 76957Minnesota Departrnent of 443 Lafayette Road No St. Paul, MN 5515 2 Phone: (651) 2 1'TY/MRS: (65 7-4198 �l� 67 ress of Ins{ 6 �Oq 7G3 •- Contrador 7 %63�- and Industry Request for Electrical I Rough-In Inspedion Required? Contractor Must Schedule All Rougl ��� _ S+r�t 7 Irun �uo� \a) — u iuuua ru oa vwc,a� 7�— d SS Contrador I � EL�'�r��c, �N� - y98 hone Number Contractor I %3 - /D 99 � Yes ���� —��c��a— . . REC'D S E P 7 2007 — One Famil Dwellin /Associat��! Structure . Singie Inspection Other Than Rough-In: �—�Ready Now • Contractor Must Schedule All Final ins ections „�,� Will Schedule CityfTownship County �..�.._.. 5°�;n�iN� �ad4 Blv� N- E • - ,�y� �,��'E/ /i�,� SS3a� Electrical Utilitv . ctor License Number CAola-23 Fee Calculation New Home or Associated Structure New Dwelling Service/Power Supply 0— 400 ampere Q 535 New Dweiling Service/Power Supply 401 — 800 ampere �$60 - $100 New Home — More than 30 Feeders/Circuits (in a abovel f ) Feeders/Circuits Uo To 200 A Detached Garage or Other Associated Structure New Service/Power Supply 0— 400 ampere (dl $35 New Feeders/Circuits ( ) (a3 $6 Each dProjed Contact Pers ; m� � G�� �l � D�{l? F�cisting Home/Structure Remodel .idditlon New Service/Power Supply 0— 400 ampe� .,., $35 New Service/Power Supply 401 — 800 amp� .,$60 ars/CErc�i.s — Up to 1� Feeders/C+rcuiEs Feeders/Circuits �$6 Each or 16 to 30 ( a �rs/Circuits — More Than 30 Feeders/Clrc� .ts 1 Feeders/Circuits Un to 200 A C� S6 E�: ( ) Feeders/Circuits � 32 Each � Detached Garage or Other Associat�^i Structure New Service/Power Supply 0-400 ampere "$35 New Feeders/Circuits ( )@ 36 E� h Reconneded Feeders/Circuits ( ) Q S2 Esu•h - - - - ,$'H: i�Lir aa � ' Totel (the fee calarlated above or $35 multiplied � TOtal (the fee calculated above or $35 multiplied by tha number of requfred inspedion trips, by the number of required inspection trips, 7Q �� whichever is greater) whichever is greater) .. Requests tor Eleetricai InspacUon (REI) with a fee of 5250 or less expire 12 months from the flling date. The contractor must have the : compisted wifhln , ths 12 month peflod or submk anothsr REI that includes the Inspection fee for the uncompletsd work. Inspeetion fees do not carry Irom on� REI to another. A aervice eharge of S30 will be added for all dishonored checks. I hereby cerdfy that I inspected the elecUiql installation heretn on the dates stated: For Department Use Only Rough - In Inspection(s) ��.� Date �' ��...,r.� u- i-�.� . ( �-�--�-�-�-�- � ^ � - ° 7 I This mabrlal can be mads available in different fom�s, such as large print, Braille or on a TDD (6d1) 297-4198. REI 02 (6/0� a1,(DIAL-DLI) Voke or