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P - 75321Minnesota De '' ent of Labor and Industry 443 Lafayett oad North St. Paul, M . 55155�342 Phone: ( ) 284-5064 TTY/M . (651) 297-4198 www.e ricity.state.mn.us Contractor Re uest for Electrical Ins Date Rough-In Inspection Required? 02/26/08 Contractor Must Schedule All Rou h-In Address of Inspection — Street 5290 SAINT IMIER DRIVE NE CHAUDHARY SATVEER �o � Numbe,f(s)� Contractor Name SOUTH SIDE (95?)888-550a Contractor Authori; tion — One Famil � Dwelli Yes Single Inspection Other Tha �ctions Contractor Must Schedule A City/Township FRIDLEY ���%� Associated Structure �gh-In: � Ready Now al Inspections � Will Schedule County u�n�si���,�, ��C[�i � GARAGE/ENTRY ADDITION. n�r . sc . �� oiy� Contractor Mailing Address CT C, INC. 9201 E. BLOOMINGTON FRWY, BLOOMINGTON, MN 55420 Number Contractor E-mail Address , Electrical Utility Signature Contractor License Number CA01695 Fee Calculation New Home or Associated Structure New Dwelling Service/Power Supply 0— 400 ampere @$35 New Dwelling Service/Power Supply 401 — 800 ampere @$60 New Dwelling Feeders/C ucri�' ds ' Up to 30 Feeders/Circuits - $10i New Home — More than 30 Feeders/Circuits (in addition to above) ( ) Feeders/Circuits Up To 200 A $6 Each Other (Speciy) Detached Garage or Other Associated Structure New Service/Power Supply 0— 400 ampere @$35 New Feeders/Circuits ( ) @ $6 Each Other Job/Project Contact 952-292-8419 Existing Home/Structure Remodel or Addition New Service/Power Supply 0— 400 ampere @$35 New Service/Power Supply 401 — 800 ampere @$60 New/F�ctended FeederslCircuits — Up to 15 Feeders/Circu�s 12 Feeders/Circuits $6 Each or 16 to 30 $100 New/Extended Feeders/Circuits — More Than 30 Feeders/Circuits Feeders/Circuits U to 200 A $6 Each Reconneded Feeders/Circuits Detached Garage or Other Associated Structure New Servics/Power Supply 0-400 ampere @$35 New/Extended Feeders/Circuits ( ) @ $6 Each Reconnected Feeders/Circuits ( ) @ $2 Each � viai �[ne ree caicwated above or $35 multiplied Total (the fee calculated above or $35 multiplied by the number of required inspedion trips, by the number of required inspection trips, whichever is greater) whichever is greater) Requests for Electrlcal Inspectlon (REI) with a fee of $250 or less explre 12 months from the flling date. The contractor must have the the 12 month peNod or submft another REI that Inctudes the Inspectlon fee for the uncompleted work. InspecUon fees do not ca another. A servlce charge of $30 wtll be added for all dlshonored checks. I hereby csrtify that I inspected the el�tripl installation herein on the dat tated• $72 �� 5 U from one REI to Rough — In Inspe ' s) � ta es ' � For Departrn O ��� � �-- -��' �`��—�r'��� � Final Inspection �--- � Date Thls materlal can be made TDD (6b1) 297-4798. REI 02 (6/07) � ` � �� torms, such as large print, Brallle or on a tape. To C.�/ � Voice or