P - 75575M(nne '' ta'Qepartment of Labcr and Industry
443 � � ette Road North
St. Paul, N 55155-4342
Phone: 1) 2845084
TTYMIR �� (6511287-4198
Date I �ugh-In Inspedion Required?
�- 3 �• 1� Contre�r/EmPloYer Must Schi
a
Address of Inspectlon - Street
Z�i S L o��� ��c� �IL �.I�� �
Owner Name �`
�M � � �- N�.1;10 ��
Owner Telephone Numbe�(sj — inalude Area
�� 3. � �N � �y 2 �
Canb�adodRegistered Employer Name
SUBURBAN ELECTRIC, INC.
Yes
������/
g (2��
��p FE� � 1200�
for Electrical Inspection
rtylTownship County
�i c�l� . �►o
�ject Descri �on �
�lec-F�-it�,l �� ��v��c�
�'� I � c��✓�1 �v�-T
'14800 28TH AVE N, SUITE 125, PL
763-498-7215 _L!
� �� � �'�''�-- � , CR02503 _ _ I �
� � ' FRe Calr.ulatiun
—
Service/Power Supply 0- 400 amp�re @$35 Technology System Devic�
� Separete 9ondfng InspecUor
ServicelPower Suppfy 401- 800 empere �$80 E ul tential Plenes
Center Pivot Irrigati�n Boom
Servic�/Power Supply Al�ove 800 ampeae (c� $100 P�� �_�
I
�
Ready Now
wiu swi �,ed�ie
�,
� ( .�-�
MN 55447
( ) (� 75¢ Each
New/Extended Feeders/Circufts Up Ta 200 A( )�$6 Each Luminaire Retroflt Modiflcetlons (
Fe�ers/Ctrcu�ts F�bove 200 A ( )(a� $15 Each Concrete-Encased Eleclrod� Inspectfan (
Investlgattve F�3e $70 Or The Totad Inspei
Recon iected Feeders/Circuits { ) (� $2 Eech
Whlche��er �s Greeter Up To $1,000
Speclal Inapectlon Fee ( ) Hours
Menufr�ctured Home Park Lot Supply ( )@$35 Each p�us Mlles The IRS MU
Recreatlonal Vehicle Sfte Suoolv Eaulament Other
) � 25¢ Each
) @ $35 Each
0 Per H
Rete of
Street, Paricing Lot, Ughtlng Standard ( ) Ca� $5 Each Over 600 Volts - a�d rr� mm�ea ��cm� �r �+a reeaenm►�ac rea m
�un m aa,n� ure r�►rae �a�e �►�ay w��� �sn m�a ou� ue�)
� ( ) New Multl-Family Dweltin� @ $70 Eech
Transformers Up to.10 kva ( )�$15 Eech � Up To 20 Feeders/Circa�its
Transformers Over 10 kva ( )�$30 Each ( ) Addidanal CUcuita Above The 20 Allow� Per Unit
6 Each
Electric Signs end OuUlne Lighting Totel (the fee. calcul� abcve or $35 muiUpli�
Transformers/Power Su Iles $5 Each by the nurtiber oi required inspecUon Mps, 3,S * j�
whichever is greater)
Requeats for Electrical Inspeetlon (REI).witl� a tee of $260 or less expUe 12 montha from tFre tiling date. The aoMrectorlemPloysr muat have tha arork
completed wlthin the 12 month pariod m submit another REI tltet dnh�des the Inel�edon fee r the uncompleted work. Ir��ctlon tees d� ��enY over
hom o� REI ta another.
/� r L j- '�` ��- `' � A 88rviee of $30 vMlp f�e BddBd fOr ell horMred atl8cks.
I hereby cerdfy tl�et I inspected the electrtcal i�llatlon herein on tlre dams skated: For Department Use Only
Rough - In Inspectlon(s) Date q
�_� - d - - � r i
7his materiat can be made evailable In diftere�rt forms, auch qs Isrge priM, Braflle or on a tape. To requsst, cell 1-800-342-8354 (DIAL-�Ui Volce or
TDD (8S1) 29T11198. �
REI 03 (6/07) ,