P - 75831REQUEST FOR ELECTRICAL INSPECTION � `'
1- 9 7 5� 7 91 � Minnesota Board of Electricity H51320
1821 University Avenue Suke 5-128, $aint:P,aul, " ta 55104
(651) 642-0800 TTY/MRS 1-500-627-3529 'c' .state.mn.us
DaSCribe -using the back of the white copy ff necessary - the work �rer�i by thia request:
WIRE FURNACE WIRE AIR C NDIT ONING
GENERAL FEES Outd�r Linhtina Standard an. $1
Abo�re 800 re$75 Transfortners ovet 10 KVA $ 20 �
.UffS / FEEDERS Transformer / Power Su I for S' r�s / OuUme Li $5
0 to 200 Am re $5 ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am re$10 Includes the Service andlor Power Supply up to 540 Amperas, All
tM, COMMUNICATION, REMOTE CONTROL, SIGNALING C'vcuits and Twro Inspection Trips Each Dwelling Unit @$80
,UITS, CIRCUITS OF LESS THAN 50 VOLTS AddiGonal Ins 'on Tri $20
Each System Device or A paratus @$.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reins 'on Fee $20
fIFAMILY DWELLINGS PER UN TOTAL FEE
3 to 12 Units @$50 Per Unit (minimum total fee is $20) �20.�J�
Each Additlonal Unit @ $25 TM°"�AF0R0�"0R1�01�Y
OTHER ADDITIONAL FEES
Uah�rm Retrofit na 5.25 oer Fixture �.-. -- .I herebv �h� that I e�spected thealearical h�stsllaUon desaibed hera9n m tde datessleted: -. -.
Hour
IIII IIIII II III �III �IIII II III II III IIIII �W I�II
19757913
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°�3/09/06 Rough-in Inspec�on Required7 ❑Yes No Inapecdon OtherThan Rough-In. Ready Now �Wi� Cell
Yau must call the inspedor when readyl Date Ready:
I certify that I am the� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at
J��`����. 100 PANORAMA AVE NE �IDLEY
10D PANORAMA AVE NE
���9�i�"�CECTRIC INC
Mailing Address (Contrador, Company or Owner Pertorming Installadc
14800 28TH AVE N. SUITE 125. PL
I�
(� rvumner , .mascer •-��^•^,.,a� or rowec �Rnrtea
License Number
, MN 55447 '
Please Provide Twro (2) Phone Numbers Including Are
(163�98-7215 ( )
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