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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