P - 75652Minnesota Department of Labor �nd Industry
443 Lafayette,�2oad North
St. Paul, MI�,�55155-4342
Phone: (6 " 284-5064
TTY/MR (651) 297-4198
www.ele 'city.state.mn.us
Co actor Re uest for Electrical Ins
Date Rough-In Inspection Required?
07/01/2008 �ntractor Must Schedule All Rou h-In
Address of Inspection — Street
1257 ONONDAGA S�
Owner Name
S & D INVESTMENTS
Owner Telephone Number(s) — Include Area Code(s)
Contractor Name
JNK ELECTRIC
Contractor Tefephone Number
(612) 840-1154
r�P✓—
:tion — One Famil Dwellir
Yes Single Inspection Other Than
�tions Contractor Must Schedule All
g/Associated Structure
Rough-In: ✓� Ready Now
Final Inspections � Will Schedule
FRIDLEY � ANOKA
Project Description
INSTALL 100 AMP SERVICE & FEEDER
Contractor Mailing Address
321 QUINCY ST NE; MPLS MN 55a413
Contraetor E-mail Address
� � �°����`�'A�� ;
Contractor License Number
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
Up to 30 Feeders/Circuits - $100
New Home — More than 30 Feeders/Circuits (in addition to
above) ( ) Feeders/Circuits Up To 200 A@$6 Each
Detached Garage or Other Associated Structure
New Service/Power Supply
New Feeders/Circuits
(SPecifY)
0 — 400 ampere @ $35
( ) @ $6 Each
Utility
Person
JOHN KOURI
Existing Home/Structure Remodel or Ac9dition
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 C� $6 Each
( ) reeciers/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 (Soecifvl
$35
�
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, $41 0�
whichever is greater) whichever is greater) Q
R�u�ts for Electrical Ins�ction (REI) with a fee of $250 or less expire 12 months from the flling date. The contractor must have the work completed wfthin
the 12 month period or submit another REI that includes the inspection fee for the uncompleted work. Inspection fe� do not carry over from one REI to
another.
A service charge of $30 wlll be added for all dish ored checks.
I hereby certify that I inspeded the eledrical instaliation herein on the dates stated: �,- For Department Use Only
Rough — In Inspection(s) � Date ,
Final Inspection
This material can � made
TDD (651) 297-4198.
REI 02 (6/07)
,Date
such as
�� ����� �
�cro � u � a 9 2ooa
or on a tape. To request, ca11 1-8p0.;
or