P - 80184REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1-396-150 � 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
Identify the work covered by this requesY.
V�EW ❑ REMODEL 0 ADDITION ❑ REPAIR XCEL ENERK�Y SAVER�S SWITCH
0 to 400 Ampere � $�
401 to 800 Amoere �
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or paratus �$.50
ADDITIONS TO THE GENERAL FEES
�
Boom
Recreational
Transformers uo to 10 KVA �
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ONE & TWO FAMfLY DWELLINGS, EACH UNiT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unft �$f
AddiNonal Insoecdon Trios � $20
FOfl INSPECTOfl USE ONLY
I hereby certify Mat 1
ROUGNIN
FMUL
is
Ne electriCal insislletion described herein on ihe dates stated:
DATE
DATE
FOR OFFICE USE ONLY
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* 1 3961 503* � �p��
Reque�f 8�A2 Rough-in Inspectian Required? ❑ Yes G�NO Inspection Other Than Rough-in: 6�Ready Now ❑ WIN CaN
You must call the inspeclor when ready! Date Ready:
I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspectlon of the electrical work at:
Job Address�St�, BoK�Y rv� � City F��Y Zp Code �3�
Section Township Range Fire No. County A�ia
Occupant PFwne
a�inisrci Rav� E
aoWe� su�ne� ^
XCEL ENERGY �
ElecMcal Contractor / Company Name ContraCtor License Number Master License Number
HUNT ELECTRIC C4RP4RATION CA 00883
Mailing Address LCon�tra�ct�or, Com ny or Owner Performin Installation)
2300 TEf�IT�i21�IL I�AD , SAINIBPAUL, MN 55114
Authorized nature (�tracto�Companyl or Owner Performing Irtstallation) Phone
451 6�2911
EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY