P - 76728Minnesota De Rment of Labor and lndustry
443 Lafayette� oad North
St. Paui, M 55155-4342
Phone: {6 284-5064
TTY/MRS: 651) 297-4198
www.elect ity.state.mn.us
Contr tor Re uest for Electrical
Date Rough-in Inspection Required?
2'2-Q8 Contractor Must Schedule All Rou
Address of lnspection — Street
176 RIVER EDGE WAY
Owner Name
DENNIS GRUHLKE
Owner Telephone Number(s) — Include Area Code(s)
(763) 571-4680
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�'�r
:tion - One Famil Dwellin /Associated Structure
Yes Single Inspeetion Other Than Rough-In: Ready Now
�ctions Contractor Must Schedule A11 Pinat Inspedions ✓Q VilN Schedule
City/Township County
FRIDLEY ANOKA
Project Description
100 AMP. FUSES TO 70Q AMP. CIRCUIT BREAKERS
Contrador Name Contractor Mailing Address
SCHOO ELECTRIC 11237 CEDAR POINTE DR. N., MINNETONKA, MN 55305
Contractor Telephone Number Contractor E-mail Address Electrical Utility
(763) 537-4731 schoozy@aol.com
Contractor Authorized ' nature Contractor License Number Job/Project Contact Person
�' CA01640 JOE SCHOO
Fee Ca(cuiation
New Hom� or Associated Structure
New Dvwelling Service/Power Supply 0— 400 ampere (dl $35
New Dwelling Service/Power Supply 401 — 800 ampere (c� $60
to 30
Feeders/Circuits Ua To 200 A
Other (Speafy)
�n-�
i to
Each
Detached Garage or Other Associated Structure
New ServicelPower Supply 0— 400 ampere (� $35
New Feeders/Circuits ( ) � $6 Each
ExfstMg Hmr�tStructure Remodet or �tdditfart
New Service/Power Supply G�, 0— 400 ampere �$35
New Service/Power Supply 401 — 800 ampere cQ $60
New/Extended FeederslCircuits — Up to 15 Feeders/Circuits
FeederslCircuits $6 Each or 16 to 30 $100
idewlExtended FeederslCircuib — Mo�e Tfien 34 FeederslCifcuits
to 200 A Ct� $6 Each
( �r ) Feeders/Circuits (d $2 Each (
Detached Garage or Other Associated Structure
New Service/Power Supply 0— 400 ampere �$35
New/Extended Feeders/Circuits ( ) � $6 Each
Reconnected FeederslCircuits ( ) � $2 Each
$35
s
Totdl (the fee catculated above or $35 multiplied TOtal (the fee calculated above or $35 multip{ied
by the number of required inspection trips, by the number of required inspection trips, 2� 5�
whichever is greater) whichever is greater) �
RequesYs for Electrlcal lnspection (REI) with a fee of SZSO or less exptre 12 months irom the tfling date. The contractor must have the work completed wlthln
the 12 month period or submit another REI that includes the inspection fee for the uncompleted work. Inspectlon feea do not carry over trom one REI to
another.
A service charye of S30 wltl be added for all dlshonored checks.
I hereby certify that I inspected the electrical installation herein on the dates shated: For DeparEment Use Only
Rough — In Inspection(s) Date
rmai mspection uate
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This material can be made available in different forms, such as large �
TDD {651) 297-d188.
REI 02 (6/07)
REC'D � � n - � �QOB
or on a
Voice or