P - 75505Minnesota De rtment of Labor and Industry
443 Lafayette oad North
St. Paul, MN 5155-4342
Phone: (65 284-5064
TTY/M RS: 51) 297-4198
www.elect 'ty.state.mn.us
Contractor Re uest for Electrical In
Date Rough-In Inspection Required?
09/23/2008 �ntractor Must Schedule All Rou h-I
Address of Inspection — Street
1026 NORTH CIRCLE
Owner Name
ALL AMERICAN HOMES
Owner Telephone Number(s) — Include Area Code(s)
Contractor Name
JNK ELECTRIC
Contractor Telephone Number
(612) 8_40-1154
tion — One Famil Dwellin /Associated Structure
Yes Single Inspection Other Than Rough-In: ✓0 Ready Now
�ctions Contractor Must Schedule All Final Ins ections ❑ Will Schedule
City/Township County
FRIDLEY ANOKA
Project Description
INSTALL 100 AMP FEEDER
Contractor Mailing Address
321 QUINCY ST NE; MPLS MN 55413
Contractor E-mail Address
CA00905
Fee Calculation
New Home or Associated Structure
New Dwelling Service/Power Supply 0— 400 ampere @$35
New Dwelling Service/Power Supply 401 — 800 ampere @$60
New Dwelling Feeders/Circuits
Up to 30 Feeders/Circuits - $100
New Home — More than 30 Feeders/Circuits (in addition to
abovel( ) Feeders(Circuits Up To 200 A[� $6 Each
Detached Garage or Other Associated Structure
New Service/Power Supply
New Feeders/Circuits
0 — 400 ampere @ $35
( ) @ $6 Each
Job/Project ConU
JOHN KOURI
F�cisting Home/Structure Remodel or Addition
New Service/Power Supply 0— 400 ampere @$35
New Service/Power Supply 401 — 800 ampere @$60
New/Extended Feeders/Circuits — Up to 15 Feeders/Circuits
( 1 ) Feeders/Circuits @$6 Each or 16 to 30 $100
New/Extended Feeders/Circuits — More Than 30 Feeders/Circui
( ) Feeders/Circuits Up to 200 A $6 Each
Reconnected Feeders/Circuits
( ) 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
�
Total (the fee calculated above or $35 multiplied Totel (the fee calculated above or $35 multiplied �y�, �j)
by the number of required inspection trips, by the number of required inspection trips, �,
whichever is greater) whichever is greater)
R�uests for Electrical Inspection (REI) wtth a fee of $250 or less expire 12 months from the flling date. The contractor must have the work completed wtthin
the 12 month perlod or submit another REI that Includes the Inspection fee for the uncomplet work. Inspection fe� do not carty over from one REI to
another.
A service charge of $30 will be added for all honored checks.
I hereby certify that I inspected the electrical installation herein on the dates stated: or Depa ment Use Only
Rough — In Inspe�tion(s)
Inspection
Date
Date
���� � � � � �
REC'D OCT 0 9 200�
Thls materlal can be made avallable in different forms, such as large print, Brallle or on a tape. To request,
TDD (651) 297-4198.
REI 02 (6/07)
Voice or