P - 80174REQUEST FOR ELECTRICAL INSPECTION
' Minnesota Board of Electricity _
, 1-396-161 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-500-627-3529
www. electricity.state.mn. us
Identify the work covered by this request:
❑�IEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
0 to 400 Ai
ao� to aoo
Above 800
:UITS / FEI
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
�� Each System Device or Apparatus �$•50
MILY DWELLINGS (PER
12 Units � $50 Per Unit
i Additional Unit � $25
�fit � $25 per Fixlure
Irrigation Boom � $40
i Home Park Lots � $
Vehicle Park Sites � I
XCEL ENERQY SAVER'S SWITCH
Transtortners u to 10 KVA �$10
Transfortners over 10 KVA � $20
Transformers I Power Supply for Si9ns I Outline Lighting �$`.
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Suppty up to 500 Amperes, Ali
Circuits and Two Inspection Trips Each Dwelling Und �$80
Additional Inspection Trips (� $20
Fee �
TOTAL FEE
total fee is $20)
FOR INSPECTOP USE ONLY
I hereby cerMy that I inspected the electricel installatlon described hereln on the tletes stated:
ROUGH IN �A�
FlNAL INSPECTION /'"O;' �A�
� �-30 - G3
FOR OFFICE USE ONLY
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* 1 3 9 6 1 6 1 0'' ''��� �� �
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Requesipete�2 Rough-in Inspection Required? ❑Yes allo Inspection Other Than Fough-in: nReady Now ❑ Will Call
fJt31� aG X
You must call the inspector when ready! Date Ready:
I certlty that I am the Ijd LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
1010 MISSISSI�1 ST NE FRIOLEY 55432
Section Township Range Fire No. County Aa�A
Oxupant Phone
UNDSTRaM EUf3ENE R
Power Supplier Add � ` :
� �Y U
Electrical Contrador / Company Name Contractor License Number Master License Number
HUNT ELEGTRIC CORF'ORATI4N CA 00$83
Mailing Address (Contractor, Company or Owner Performing Installation)
23t10 TERRITfJRIAI lZOAD , SAINtT PAUL., MN 55114
Authorized Si nature (Contractor, Com n or Owner Performing Installation) Phone
3ww��R� 651 6�if-2911
EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY