P - 80317REQUEST FOR ELECTRICAL INSPECTION �
�� 916 � 7 5 4� Minnesota State Board of Electricity �
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104-2993
(651) 642-0800 www.electricity.state.mn.us `���
('ITY
�Home Duplex Apt. Bldg. Other: New Addn
AIr Conditioner Hfg. Equip. Water Htr. Load Mgmt. Other. "
Dryer Range Elec. Heat Temp. Service
"X" above the work covered by this request. Enter remarks in this space and on the back of the white copy only.
T8342 — INSTALL TRANSFORMER FOR NE''✓� DISTRIBUTION. SEE
DALE 1JAWALLSKT ON SITE.
Calculate Inspection Fee - This Inspection Request will not be accepied withoui the correct fee:
Other Installations Fee # Service Enfrance Size Fee # Circuits / Feeders Fee
Mobile Home Park Stall . 0 to 200 Amps 0 to 100 Amps
Street raffic Sig. Above 200 Amps Above 100 Amps
Trans r / r t{�ISPECTOR'S USE ONLY TOTAL
Sign y utline Ltg. Xfmr. L,�}., (��� 10 5. 5 0
Alarm/Remote Control
��- �— 4
Swimming Pool
I hereb certi fhat I ins ected elecfrical installation described herein on fhe dafes sfafed: -
Irrigation Boom Rough-In /i _ _ _ pa�_ � �
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THIS INSTALLATION MAY SE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validatfon date printed in this box. �
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PLEASE PRINT OR TYPE
Requesf Date Rough-in inspection required� Yes ❑ No Inspecfion Ofher Than Rough-In; � Ready Now`� Will Call
3/ 2�/ O O You musf call the inspecfor whe�dy Date Ready: 1S
I, � licensed co�tractor ❑ company ❑ owner hereby request inspection of the above electrical work at: