P - 78989REQUEST FOR ELECTRICAL {NSPECTION
1�"� C� 8•— � 7 7 � Minnesota Board of Electricity -
1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651)642-0800TTY/MRS1-800-627-3529 ww+v.electricity.state.mn.us
❑ NEW O REMODEL O ADDITiON ❑ REPAIR Describe -using the back of the white copy if necessary - the work covered by this request:
TEMPORARY SERVICE
GENERAL FEES Outdoor Li htin Standard $1
SERVICES I POWER SUPPLIES Traffic Si nal Standard $5
0 to 400 Am re $25 Su lement� Fee $2(1
4�1 ta 800 Ampere �$50 Transformers uo to 10 KVA (d $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or aratus $.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNIT
3 to 12 Units @$50 Per Unit
Each Additional Unit @ $25
OTHER ADDITIONAL fEES
Li htin Retrofit $.25 r Fixture
Center Pivotl ' ation Boom $40
Manufaclured Home Park Lots a25
Recreational Vehicle Park Sites �$5 �!1 n.<
�I�I II II� II ��I II ��I II lll �� III II III II ��I �� I�
14683775
�V� �� Roug�-in Inspecti0n R¢quiretl7 Yes
6-18 — 0 3 You musl call the i�spector ready!
I c�rtify that I am the CENSED CONTRACTOR ❑ OMPAN
1110 NORTON AVENUE
ONE & TWO FAMILY DWELLIN�S, EACH UNIT
Includes ihe Service and/a Power Supply up to 5U0 Amperes, All
Circuits and Two InspecGon Trips Each Dwelling Unit �$60
TOTAL FEE
(minimum total fee is $20) 3 0. 5 0
THIS AREA FOR INSPECiOR u5E IXiY
I hereby ceNry Mat I inspected Me elec4ic� i�taNation desuibed herein on tlie datrs st�d:
�3y�� � � .
� � �
1 No Inspedion Olher Than Rough-In: ❑Ready Now � WNI Call
Date Ready:
❑ OWNER and hereby request mspection of the �I worlc at:
FRIDLEY
�w.n,wg,�.n neme, n r�ease Provae rwo (z� pnane nwnber(s) uaudng area coae
P M J HOMES ���t3%� ( ) ( )
ower supp�rer Power suaa��e• ndere�
XCEL ENERGY
onuadw, vanr Name c«,aacfor L;cense Number nAa�r Eiecn�ian « Fower Limned aMieian
WEST STAR ELEC'�'�2IC, INC. CA01936 �"`�bef
lai�ing nadress �cw�aaaor, compa„y a ow�er Peit«m;�g Insteaauo„>
324 LAKELAN AVE N BROOKLYN PARK MN 55428
�' ( r o. aerrom,ug trismuanon) ano�e �s)
763 537-0807
�sne an e�c caPr eawu oF �cTwcm coav Ee�a000��-u e.�. zoox