P - 75555�+�(!t�)i�
Minnesota �Departme of Labor and Industry
44� Lafayette Road; orth
St. Paul, MN 5515�4342
Phone: (651) 2 5064
TTY/MRS: (65 297-4198
www.electrici te.mn.us
Contra or Re uest for Electrical Ins
Date Rough-In Inspection Required?
08/14/2008 Contractor Must Schedule All Rou h-In
Address of Inspection — Street
6160 RICE CREEK DRIVE
Owner Name
KEMAL BALIOGLU
Owmer Telephone
(763) 502-1596
i�a� — n �c�uue ru ea �
i51) 329-4501
Contractor Name
CENTERPOINT ENERGY
�tion — One Famil / Dwelli
Yes Single Inspection Other Tha
ociated Structure
i� ❑ Ready Now
Contractor Must Schedule All Final Ins ections ✓❑ Will Schedule
City/Township County
FRIDLEY ANOKA
Project Description
WIRE/ RECONNECT FURNACE AND AIR
CONDITIONER
c:onvactor mamng Aadress
9320 EVERGREEN BLVD NW SUITE B COON RAPIDS. MN 55433
(763) 757-6202 joann.zinken@CenterPointEne
Con ctor Authorized Signature Contractor License Number
CA01796
Fee Calculation
or Associated Structure
New Dwelling Service/Power Supply 0— 4 }�er�@ $35
New Dwelling Senrice/Power Supply 401 — 800 ampere @$60
HTawlluiollinnFnne�lnrc/(�im��ifc-- --
Up to 30 Feeders/Circuits - $100
New Home — More than 30 Feeders/Circuits (in addition to
above) ( ) Feeders/Circuits Up To 200 A C� $6 Each
Detached Garage or Other Associated Structure
New Service/Power Supply 0— 400 ampere @$35
New Feeders/Circuits ( ) @ $6 Each
(Specifjr)
Eiectncal utility
Job/ProJect Contact Person
JOANN ZINKEN
Existing Home/Structure Remodel or Addition
New Service/Power Supply 0— 400 ampere @$35
New Service/Power Supply 401— 800 ampere @$60
1VewlExtenc�ed Feeders/Circu�s - Up to 15 Feede�/Circuits
Feeders/Circuits $6 Each or 16 to 30 $100
NPw/FxtPnrlarl Faarlarc/rirr� iiM _ Mnro Th�n zn Go�m.�ir�.,.� �h�
Each
Reconnected
( 2 ) Feeders/Circuits $2 Each I �'
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
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, 3S Sd
whichever is greater) whichever is greater)
Requests for Electrfcal Inspectlon (REI) wtth a fee of $250 or less explre 12 months from the flling date. The cor�tractor must have the work completed wlthln
the 12 month period or submft another REI that includes the Inspection fee for the uncompleted work. Irispection fees do not carry over from one REI to
another.
A servlce charge of $30 will be added for aIl dishonored checks.
I hereby certify that I inspeded the electrical installation herein on the dates stated: For Departrnent Use Only
Rough — In Inspection(s) q Date
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TDD (651) 297-4198.
REI 02 (6/0�
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Date� C'� �C� h1U�7 � p �QD$
as targe print, Braille or on a tape. To request, call 1-800-;
or