P - 80465REQUEST FOR ELECTRICAL INSPECTION
' Minnesota Board of Efectricity
c. � 1-381-459 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electriciry, sta te. mn. us
Identify the work covered by this request:
U ItlEW ❑ REMODEL ❑ ADDITION
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTFOL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or Ap aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMIIY DWELLINGS (PER UNIT)
3 to 12 Units �$50 Per Unit
Each Additional Unit � �25
Lighting Retrofit � $25 per Fixture
Cenfer Pivot Irripation Boom � $4C
XCEL ENERGY �AVER'� �WITCH
Transformers u to 70 KVA �$10
Transformers over 10 KVA � $20
Transfortners / Power Supply for Signs / Outline Lighting �$!
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$80
Additional Inspection Trips � $20
FOF INSPECTOF USE ONLV
I hereby certify thet I
ROUGH IN
FINAL INSPECTION
7
TOTAL FEE
d fee is $201
DATE
�"-7 27�f1
FOR OFFICE USE ONLY
I{INIINIIININIIIiIIi������ �-���
'` 1 381 4595* ����
Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than Rough-in: Ready Now ❑ Will Call
�g��� You must call the inspector when ready! Date Ready:
I certity that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
Job Address (Street, Box, or Route No.) Ciry Zip Code
7'S01 LYRIC LN NE FRIDLEY 55432
Section Township Range Fre No. County
ANC1ltA
Occupant Phone
KELLNER JENNIFER L � � � � '
Power Supplier Address
XCEL ENERGY
Electricel Contrac[or / Company Name Contractor License Number Master Ucense Numher
HUNT ELECTRIC CORPf�RAT14N CA 00883
Mailing Address (Contractor, Company or Owner Performing Instalfalion)
2300 TERRITORIAL RDAD , SAINT PAUL, MN 55114
Authorized Signature (Contractor, Company or Owner Perfortning InStallation) Phone
861 8d&291 t
E&00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY