P - 80463. REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
• 1-381-461 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1•800-627-3529
www. e%ctricity. state. mn. us
Identiiy the work covered by this request:
�'�7EW ❑ REMODEI ❑ ADDITION O REPAIR
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUI7S OF LESS THAN 50 VOLTS
Each System Device or Ap aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNIT)
3 to 12 Units �$50 Per Unit
Each Addi6onal Unit � $25
Home
kCEL EtVERGY �AVER'� �WITeFi
Transformers u to 10 KVA �$10
Transtortners over 10 KVA � $20
Transfortners / Power Supply for Signs / Outline Lighting �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit (� $80
AddiNonal Inspection Trips � $20
Investi ative Fee
Reinspection Fee � $20
TOTAL FEE
(minimum total fee is $20)
FOR INSPECTOF USE ONLV
i nereby ���ry ma� i
ROUGH IN
FINAL WSPECTION
0
FOR OFFICE USE ONLY
11�l��I������Ifl��������ll�ll��l����lq� r�g��1
* � � .�
1 381 461 1 �J�
Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than Fough-in: ❑ Ready Now ❑ WIII Call
�$��1 You must call the inspector when ready! Date Ready:
I certify that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecNon of the electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
1682 �7SBaRNE RD NE FRIGLEY 55432
Section Township Range Fire No. County
ANCtFiA
Occupant �; +-1 � �� L� Phone
WEISEN GUANE C � �
Power Supplier Address
XCEL ENERGY
Electrical Contractor / Company Name Contractor License Number Master License Number
HUNT ELEGTRtC CORPQRATIQN CA 00683
Mailing Address (Contractor, Company or Owner Pertorming Installation)
2�lD TERRITORIAL Rf�AD , SAINT PAUL, MN 5611 a
AWhorized Signature (Contrador, Company or Owner Performing Installation) Phone
9fi1 848-291 i
EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY