P - 80464� ' REQUEST FOR ELECTRICAL INSPECTION
j , Minnesota Board of Electricity
• 1-381-460 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us ' �
identify the work covered by this request:
U'I�EW ❑ REMODEL ❑ ADDITION ❑ REPAIR XCEL ENERGY �AVER�S SWITGH
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES 1 POWER SUPPLIES Trattic Siqnal Standard �$5
ALARM, COMMUNICATION, REMOTE CONTROL, SIG�
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Ap aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFRMILY DWELLINGS (PER UNf�
3 to 12 Units �$50 Per Unit
� Retrofit � $25 per Fixture
Pivot Irri4ation Boom � $4C
Mile
Transfortners u to 10 KVA �$10
Transformers over 10 KVA � $20
� Transformers J Power Supply for Signs 1 Outline Lighting �$5
ONE 8 TWO FAMILY DWEILINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Tnps Each Dwelling Unit �$80
Additional Inspection Trips � $20
Investi ative Fee _
Reinspection Fee � $20
TOTAL FEE
(minimum total fee is $20)
FOR INSPECTOR USE ONLY �
ROUGM IN
FINAL INSPECTION
on
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FOR OFFICE USE ONLY
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* 1 381 4603'` �'J�
Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than Rough-in: CI Ready Now L7 Will Cail
09t28/t11 You must call the inspeaor 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 NoJ Ciry Zip Code
7619 MEADC7WM�7R OR NE FRIDLEY 55' +{32
Section Township Range Fire No. County A��A
c' � j i T-�
Occupant Phone
CUMMER MICNAEL D
Power Supplier Address
XCEL ENERGY
Elechical Contractor / Company Name Conhactor Lice�se Number Master Lic:ense Number
HUNT ELE�TRI�G CORPORATION CA Q48�
Mailing Address (Contractor, Company or Owner Perfortning Installation)
2300 TEFtRITORU�IL ROAD , SAINT PAUL� MN 56114
Authorized Signature (ContraCtor, Company or Owner Perfortning Installation) Phone '
861 11
EB-00001A-13 7/1/2000 BOARD OF ELECTflICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY