P - 80183• REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1-396-152 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 —
(651) 642-OS00 TfY/MRS 1-800-627-3529
www. electricity. s ta te. mn. us
Identify the work covered by this request:
LFnEW ❑ REMODEL 0 ADDITION Q REPAIR
co
�e
i/
I CIRCUITS. CIRCUITS
Recreationai
REMOTE CONTROL, SIGNALING
SS THAN 50 VOLTS
e Park Lots � $
e Park Sites �
f1Sp8C�lOf1 � �21
� $� pQf �iOUf
� $.31 oer Mile
XCEL ENERaY SAVER'S SWITCH
Transformers uo to
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service ar�d/a Powe� 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 $201
RWGM IN
FINRL INBPECTqN
OATE
DATE
� �f 6�
FOfi OFFlCE USE ONLY
f IIIIII IIIII �III IIIII II(II I(III Ill� 11�1 �II I�I
* 1 3 9 6 1 5 2 9* ���s�
Reque�t ��2 Rough-in Inspectfon Required? ❑ Yes l�No Inspection Other Than Rough-in: �Ready Now ❑ Wfl Call
You must call the inspector when ready! Date Ready:
I certify that I am the �l LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecbon of the electrical work at:
Job Address�4�90 � l'AKESIN� RD N c�� FRIDLEY �� 55d32
Section Township ire No. County �a
�uPMC OU' WAN ROOER K Phone
Power Supplier Address
�L �Y
Electrical Contractor / Company Name Contractor License Number Master License Number
HUNT ELECTRIC CQRP4RATION CA �583
Mailing Address (Contractor, Company or Owner Performing Installation)
�00 TERRIT�IAL I�AD , SAINT PAUI., MN 55114
Authorized Si�(Contrecto:�+ r, Co�m�ny ar Owner Performing Installation) Phone
t�i1 6�16-2911
EB-OOOOtA-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK Of YELLOW COPY