P - 75504Minnesota Dep�`tment of Labor and Industry
443 Lafayette oad North
St. Paul, MN 155-4342
Phone: (651 84-5064
TTY/M RS: 1) 297-4198
www.electri y.state.mn.us
Contractor Re uest for Electrical In
Date Rough-In Inspection Required?
10/07/2008 �ntractor Must Schedule All Rou h-I
Address of Inspection — Street
7435 OAKLY
Owner Name
RICHARD KOSKIE
Owner Telephone Number(s) — Include Area Code(s)
Contractor Name
JNK ELECTRIC
Contraetor Telephone Number
(612) 840-1154
tion — One Famil Dwellin /Associ
Yes Single Inspection Other Than Rough-In:
�
�ctions Contractor Must Schedule All Final Ins ecti
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/Pawer Supply 401 — 800 ampere @$60
Up to 30 Feeders/Circuits - $100
Home — More than 30 Feeders/Circuits (in addition to
el ( 1 Feeders/Circuits Up To 200 A(a� $6 Each
Detached Garage or Other Associated Structure
New Service/Power Supply
New Feeders/Circuits
0 — 400 ampere @ $35
( ) @ $6 Each
Electrical Utility
KCEL
Job/Project Contact
JOHN KOURI
Structure
] Ready Now
] Will Schedule
Existing Home/Structure Remodel or Addition
New Service/Power Supply 0— 400 ampere @$35
New Service/Power Supply 401 — 80Q ampsre @$60
New/6ctended 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
Other (Specify)
$6
Total (the fee calculated above or $35 multiplied Total (the fee calculated above or $35 multiplied
by the number of required inspection trips, by the number of required inspection trips, $35 0 0(�
whichever is greater) whichever is greater)
Requ�ts for Electrical Inspedion (REI) wkh a fee of $250 or less expire 12 months from the flling date. The contractor must have the work completed w(thin
the 12 month period or submit another REI that includes the inspection fee for the uncompleted work. Inspectlon fees do not carry over from one REI to
another.
A service charge of S30 will be added for all dishonored checks.
I hereby certify that I inspected the electrical installation herein on the dates stated: For Department Use Only
Rough — In Inspection(s)
Inspection
This material can bi
TDD (651) 297-4198.
REI 02 (6/07)
Date
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