P - 75882REQUEST FOR ELECTRICAL INSPECTION ''
`_ 0����� ° � 821 Univers(ty A en e 3u�S-1�/28, Saint PaSul,��esota 55104 -
(651) 642-0800 TTY/MRS 1-800-627-3529 www c .state.mn.us
Describe -using ths hack of the white copY'rf necessary - the work covere�i by this reque,st:
WIRE FURI�tACE WIRE AIR CONDITIONING
W°�� �� w��� �ranstortnersover70KVA $20
CIRCUITS / FEEDERS Transformer / Power Su I for Si ns / Outline Li htin $5
0 to 200 Am re $5 ONE 8 TWO FAMILY DWELLINGS, EACH UNR
Above 200 Am $90 Indud� the Service and/or Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Ins�on Trips Each Dwellir�g Unit @$BO
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS e,�a»t.,��i i„�,.�,,.., r�.,� n con
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total fee is
I hereby certlfythet I ir�speded the el�tricel U�atalletlon d�albed herefn on ihe dat� steted:
IF NOT COMPLETED WITHIN 12
fOR OFFIC[ USE CtdLY
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V6�2��QG Rough-in Inspecdon Required? ❑Y� �jNo I Inspec8on OtherThan Rough-In�] Ready Now ❑WqI Ca0
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You must call the inapector when readyl Date Ready
I certify that I am the ,�LICENSED CONTRACTOR ❑ COMPAWY ❑ OWNER and hereby r�uest inspection of the electrical wmk at