P - 80460REQUEST FOR ELECTRICAL INSPECTION
� Minnesota Board of Electricity
� 1-381-463 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electriciry. state. mn, us
Identify the work covered by this request:
�EW ❑ REMODEL ❑ ADDITION ❑ REPAIR XCE� ENERGY SAVER'� �VUITCH
400 Ampere �
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus � Q.50
TIFAMILY DWELLINGS (PER UNIT
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIOI
Lighting Retrofit � $.25 per Fixture
Center Pivot Irrigation Boom � $4C
Manufadured Fbme Park Lots � $
Recreational VehiGe Park Sites � ;
Separate Bonding Inspection � $21
Special Inspection � S30 oer Hour
Su demental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformers / Power Su I for Si ns I Outline Li htin �$:
ONE R TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service antl/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$80
Additional Inspection Trips � $20
Fee
fOR INSPECTOR USE IXYLV
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I hereby certify Mat I inspected the electrical installation described herein on the tletes sfeted:
ROUGHIN DA7E
FINALINSPECTON .� ��s DATE
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FOR OFFICE USE ONLY
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Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than Rough-in: Ready Now ❑ Will Call
�$��� You must call the inspecta 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
28P, RICE C:REEK BLV NE FRIDLEY 55432
Section Township Range Fire No. County
ANUKA
Occupant Phone
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Power Supplier A dr
XCEL ENERCY
Electrical Contractor / Company Name Contrador License Number Master License Number
HUNT ELE�TRIC �4RPORATION CA 04883
Mailing Address (Contractor, Company or Owner Perfortning Installation)
2300 TEI�RITORIAL ROAD , SAINT PAUL, MN 55114
Authoriz9d Signature (Contractor, Company or Owner Performing Installation) Phone .
661 848-2911
EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY