P - 80461- REQUEST FOR ELECTRICAL iNSPECTION ..�8
, ' Minnesota Board of Electricity
• 1-381-462 9� 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 �
(651) 642-OS00 TTY/MRS 1-800-627•3529
www. electricity.state.mn. us
Identify the work covered by this request:
�NEW ❑ REMODEL q ADDITION ❑ REPAIR ��L ENERGY SAVER�S u;'WiTCH
0
IALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
� Each Svstem Device or Aooaratus � 5.50 �
3to12
7
Manufactured Home Park Lots �
Recreational Vehicle Park Sites �
Separate BondinqlnspecUOn � $;
i ransrormers over iu rcv,v � yzu
Transformers / Power Supply for Signs / Outline Lighting �
ONE & TWO FAMIIY DWELLiNGS, EACH UNtT
Includes the Senice and/or Power Supply up to 500 Amperes, All
Circuds and Two lnspection 7rips Each Dwelling Unit �$I
Additional Inspection Trios � $20
TOTAL FEE
total fee is $201
I nereby certiy tnat I inspectetl Me eleclricat installation tlescribed herein on Me dales a
ROUGH M . DPTE
FINALINSPECTION .� �D/ATE
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FOR OFFICE USE ONLY
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Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than Rough-in: ❑ Ready Now ❑ WIII Call
���roi You must call the inspector when ready! Date Ready:
I certify that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
6250 RAINBOW DR NE FRIDLEY' 55432
SecNon Township Range Fire No. County
ANfiM{A
Occupant (^ r° r. �.-- Phone
����il��Ci ��� j t�
Power Supplier Address
XCEL ENERGY
Electrical Contrector / Company Name Contractor License Number Master Lk:ense Number
HUNT ELEGTRIC C4RPORATI4N CA 00�83
Mailing Address (Contractor, Company or Owner Pertorming Installation)
2',�00 TERRITORIAL ROAD , SAINT PAUL, MN 56114
Authorized Signature (Contrector, Company or Owner Perfortning Installation) Phone
�1 �"�1 �
EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY