P - 80181� REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1-396-154 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. state. mn, us
Identity the work covered by this request:
LMItEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
401 to 800 Ampere �
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGI
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or Ap aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNIT)
3 to 12 Units � S50 Per Unit
25 per Fixture
i Boom � $4f
Park Lots � g
Park Sites �
Mile
XCEL ENERC�Y SAVER'S SWITGH
Transformers over 10 KVA � $20
Transformers / Power Supply for Signs / Outline Lighting �$!
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Sennce andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspectlon Trips Each Dwelling Unit �$80
Additional Inspection Trips � $20
total fee is
I hereby certify that I inspecled the electrical insfalletion describetl herein on the detes sle�ed:
ROUGMIN OATE
FINAL INSPECTION DATE
,S^2-a3
FOR OFFlCE USE ONLY
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Requesi0ate�2 Rough-in Inspection Required? ❑ Yes GINa Inspec6on Other Than Rough-in: G1Ready Now ❑ Will Call
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You must call the inspector when readyl Date Ready:
I certi(y that I am the [�j LICENSED CONTRACTOR ❑ COMPANY � OWNER and hereby request inspection of the electrical work at:
Job Address (Street, Box, or Route No.) City Zp Code
x� ueam sr n� F�o�v �
Sectlon Township an e Fire No. County ai��A
e ^, �l
Occupant . Phone
Bt7lJRBEAU KATHY A
Power Supplier Address
XCEL ENEFtGY �
Electrical Contractor / Company Name Contrador License Number Master License Number '
HUNT EIFCTRIC GORPORATION CA 00883
Mailing Address (Contractor, Company or Owner Performing Installation)
2300 TEt�tITc'�RIAL ftOAO , SAINT PAUL, MN 55114
Authorized Signature (Contractor, Company or Owner Performing Installation) Phone
� �''� �i1 6�6-2911
EB-0OOO1A-i3 7/1/2000 BOARD OF ELECTRICIN COPY INSTRUCTIONS ON BACK OF YELLOW COPY