P - 75717Minnesota Departrn ;elt of Labor and Industry
443 Lafayette Ro ��lorth
St. Paui, MN 5 5-4342
Phone: (651 5064
TfY/MRS: 1) 297-4198
www.ele ity.state.mn.us
Contractor Re uest for Electrical Ins
Date Rough-In Inspection Required?
07/10/2007 Contractor Must Schedule All Rou h-In
Address of Inspection – Street
7435 MELODY DRIVE
JOHN DE CRANS
Owner Telephone Number(s) – Include Area
(763) 792-4066 (763) 792-4066
REC'D J U L 16 2007
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tion — One Famil Dwellin /Associated Structure
Yes Single Inspection Other Than Rough-In: ❑ Ready Now
�ctions Contractor Must Schedule All Final Ins ections �❑ Will Schedule
City/Township County
FRIDLEY ANOKA
WIRE/RECONNECT AIR CONDITIONER
Contractor Name Contractor Mailing Address
CENTERPOINT ENERGY 9320 EVERGREEN BLVD NW SUITE B COON RAPIDS, MN 55433
Contractor Telephone Number Contractor E-mail Address Electrical Utility
757-6202 joann.zinken@centerpointenergy.co
ctor th e ure Contractor License Number Job/Project Contact Person
CA01796 JOANN ZINKEN
Fee Calculation
New Home or Associated Structure Existing Home/Structure Remodel or Addition
New Dwelling Service/Power Supply 0– 400 ampere @$35
New Dwelling Service/Power Supply 401 – 800 ampere @$60
_ — IVew De✓etling�eedarsJCircuits - - - - --- -- - ----
Up to 30 Feeders/Circuits - $100
New Home –
Other (Specify)
�cuits (in
To 200 ,
Detached Garage or Other Associated Structure
New Service/Power Supply
New Feeders/Circuits
Other (SaeciN)
(Specify)
0 – 400 ampere @ $35
( ) @ $6 Each
New Service/Power Supply
New Service/Power Suppiy
0 – 400 ampere @ $35
401 – 800 ampere @ $60
t� =tigto 15 �eedetsiEircuits
$6 Each or 16 to 30 @$100
– More Than 30 Feeders/Circui
Its Uo to 200 A(a� $6 Each
( ) Feeders/Circuits @ $2 Each �
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 O otal (the fee calculated above or $35 multiplied
by the number of required inspection trips, �j y the number of required inspection trips,
whichever is greater) �' whichever is greater)
Requests for Electrical InspecUon (REI) with a fee of $250 or pire 12 months from the flling date. The contractor must have the work completed within
the 12 month period or submk 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 certity that I inspected the electrical installation herein on the dates stated: For Department Use Only
Rough – In Inspection(s) Date
Final
This material can be made
TDD (651) 297-4198.
REI 02 (6/0�
uate
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such as large print, Brallle or on a tape. To request,
Voice or