P - 75173Minnesota Departrn
443 Lafayette Road
St. Paul, MN 551
Phone: (651) 2 :
Labor and Industry
TTY/MRS: (6 297-4198
www.electrici .state.mn.us
Contra ` or Re uest for Electrical
Date Rough-In Inspection Required?
04/17/2008 Contractor Must Schedule All Rou
Address of Inspection — Street
54 LOCKE LAKE ROAD NE
tion — One Famil � Dwellin /9 Assc
Yes Single Inspection Other Than Rough-In:
:ctions Contractor Must Schedule All Final Insp
FRIDLEY
ANOKA
Structure
] Ready Now
� Will Schedule
Owner Name Projeet Description
BLAINE JONES (P �- �f�t �- �Y� s� WIRE/ RECONNECT (3) FURNACES AND (1) AIR
Owner Telephone Number(s) — Include Area Code(s) CONDITIONER
(763) 574-1180
Contractor Name
CENTERPOINT ENERGY
Contractor Telephone Idumber
(763) 757-6202
Contractor Mailing Address
9320 EVERGREEN BLVD NW SUITE B. COON RAPIDS, MN 55433
Contractor E-mail Address Electrical Utility
joann.zinken@CenterPointEnergy
Contractor License Number Job/Project Contact Person
CA01796 JOANN ZINKEN
Fee Calculation
or Associated Structure
New Dwelling Service/Power Supply 0— ere @$35
New Dwelling Service/Power Supply 401 — 800 ampere @$60
New Dwelling Feeders/Circuits
— More than 30
30 Feeders/Circuits - $
;ircuits (in addition to
in To 200 A CD $6 Each
Detached Garage or Other Associated Structure
New Service/Power Supply 0— 400 ampere @$35
New Feeders/Circuits ( ) @ $6 Each
Other (Specify)
(Specify)
Existing Home/Structure Remodel or Addition
New Senrice/Power Supply
New Service/Power Supply
Feeders/Circuits
0 — 400 ampere @ $35
401 — 800 ampere @ $60
— tTp to 'f5Feeders/�rcuiis
6Eachor16to30(tD$100
— More Than 30
ts Ua to 200 A I
------ --- ----
( 4 ) Feeders/Circuits @ $2 Each $8
Detached Garage or Other Associated Structure
New Service/Power Supply 0— 400 ampere @$35
New/Extended Feeders/Circuits ( ) @ $6 Each
Reconnected Feeders/Circuits ( ) @ $2 Each
Other (Specify)
Total (the fee calculated above or $35 multiplied Total (the fee calculated above or $35 multiplied SC��
by the number of required inspection trips, by the number of required inspection Vips, ��j '
whichever is greater) whichever is greater)
Requests for Electrical Inspection (REI) with a fee of $250 or less expire 12 months from the flling date. The contractor must have the work compteted within
the 12 month period or submit another REI that includes the inspecUon fee for the uncompleted work. Inspection fees do not carry over from one REI to
another.
A service charge of $30 will be added for all dishonored checks.
I hereby certify that I inspected the electrical installation herein on the dates stated: For Department Use Only
Rough — In Inspection(s)
Final
Date
(/ � �/c��'�� �'-�" S ' /z -� �' I
This aterial can be made avallable In d(fferent forms, such as large pMnt,
TDD (651) 297�798.
REI 02 (6/0�
o� 6� � iXj�?��
t�C'D APR 21 2008
or on a tape. To request, call 1-800-342-
or