P - 76949Minnesota Depa ent of Labor and Industry
443 Lafayette ad North
St. Paul, MN 155-4342
Phone: (65 84-5064
TTY/MRS: 51) 297-4198
www.elect ity.state.mn.us
Cont ctor Re uest for Electrical Ins
Date Rough-In Inspection Required?
09/05/2007 Contractor Must Schedule All Rou h-In
Address of Inspection — Street
7436 STINSON BLVD NE
Owner Name
SHARON MILES
Owner Telephone Number(s) - Include Area Code(s)
(763) 786-3075 (763) 571-7480
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ction - One Famil Dwellin /Associated Structure
� Yes Single Inspection Other Than Rough-In: ❑ Ready Now
�ections Contractor Must Schedule All Final Ins ections ✓❑ Will Schedule
City/Township County
FRIDLEY ANOKA
WIRE/ RECONNECT FURNACE
Contractor Name Contractor nnauing Aqdress
CENTERPOINT ENERGY 9320 EVERGREEN BLVD NW SUITE B COON RAPIDS, MN 55433
Contractor Telephone Number Contractor E-mail Address Electrical Utility
(763) 757-6202 joann.zinken@CenterPointEnergy
Contractor Authorized Signature Contractor License Number Job/Project Contact Person
CA01796 JOANN ZINKEN
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/Circuits
Other
Up to 30 Feeders/Circuits - $100
— More than 30 Feeders/Circuits (in addition to
1 Feeders/Circuits Up To 200 A C�D_ $6 Each
Detached Garage or Other Associated Structure
New Service/Power Supply
New Feeders/Circuits
Other
0 — 400 ampere @ $35
( ) @ $6 Each
Existing Home/Structure Remodel or Addition
New Service/Power Supply 0— 400 ampere @$35
New Service/Power Supply 401 — 800 ampere @$60
UCUfCCVCIJ/lrlll.UllJ-VFJW IJrCCVGIJ/Vl�VUII:
Feeders/Circuits @$6 Each or 16 to 30 @$100
ied Feeders/Circuits — More Than 30 Feeders/Circu
) Feeders/Circuits Up to 200 A@$6 Each
ed Feeders/Circuits
a
( 1 ) Feeders/Circuits @ $2 Each I $2
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
Other (Specify)
TOt81 (the fee calculated above or $35 multiplied TOtal (the fee calculated above or $35 multiplied j
by the number of required inspection trips, by the number of required inspection trips, a0
whichever is greater) whichever is greater)
Requests for Electrical Inspection (REI) with a fee of 5250 or less expire 12 months from the filing date. The contrector must have the work completed within
the 72 month period or submit another REI that includes the inspection fee for the uncompleted work. Inspection fees do not carry over from one REI to
another.
A service charge of S30 will be added for all dishonored checks.
I hereby certify that I inspecte
Rough — In Inspection(s)
herein on the dates :
Date
Final Ins ection Date
P �
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This material can be made available in different forms, such as large print,
TDD (651) 297-4198.
REI 02 (6/07)
FOf D@p01'[Rl@Ilt US@
or on a tape. To request, call 1-800-342-5354 (DIAL-DLI) Voice or