P - 75145nninnesota uepaRme t or �anor ana inausvy
443 Lafayette Road �orth
St. Paul, MN 55155-4342
Pf�ine: (6�1) 284-, 664
TTY/MRS: (651) � 7-4198 � � d 3 � � � � � I � ,
www.electricity. te.mn.us ��
Contrac r Re uest for Electrical Ins ection — One Famil Dwellin /Associated Structure
Date Rough-In Inspection Required? ❑ Yes Single Inspection Other Than Rough-In: Q Ready Now
4/24/08 Contractor Must Schedule All Rou h-In Ins ections Contractor Must Schedule All Final Ins ections ❑ Will Schedule
Address of Inspection - Street City/Township County
7500 TEMPO TERRACE FRIDLEY ANOKA
MINDY KLAUER
Owner Telephone Number(s) - Includi
(763) 780-0103
- Contractor Name - - - -
CLAUDE M ANDERSON ELEC
(651) 771-1000
�
nature
Project Description
220V WIRING FOR WALL OVEN, 110V WIRING FOR
MICROWAVE
Caritractor AA,a'tl+� Addfess -
1551 PAYNE AVE - ST PAUL 55130
Contractor E-mail Address
Contractor License
CA00171
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 Qwelting F�e� r�/Cir�uits -- -
U to 30 Feeders/Circuits - $100
New Home - More than 30 Feeders/Circuits (in addition to
above) ( ) Feeders/Circuits Uo To 200 A C�a. $6 Each
Other (Specify)
Detached Garage or Other Associated Structure
New Service/Power Supply
New Feeders/Circuits
Other (Specify)
0 - 400 ampere @ $35
( ) @ $6 Each
Utility
Job/Project Contact Person
MICHELLE
Existing Home/Structure Remodel or Addition
New Service/Power Supply 0- 400 ampere @$35
New Service/Power Supply 401 - 800 ampere @$60
Newf�xtsrtded Feeders/Eircuits - Up Yo 9 5 Feedets/Circuits
� 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
Reconnected Feeders/Circuits
Feeders/Circuits $2 Each
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)
Total (the fee calculated above or $35 multiplied Total (the fee calculated above or $35 multiplied ��1�
by the number of required inspection trips, by the number of required inspection trips,
whichever is greater) whichever is greater)
Requests for Electrical InspecUon (REI) wtth a fee of $250 or less expire 12 months from the flling date. The contractor must have the work completed wfthln
the 12 month per(od or submit another REI that includes the inspection fee for the uncompleted work. InspecUon fees do not carry over from one REI to
another.
A service charge of $30 wlll be added for all dishonored checks.
i nereoy certtty tnat 1 mspected tne elecVical installaUOn herein on
Rough - In Inspection(s)
Final Inspection
This material can be made
TDD (651) 297-4198.
uin aeic�s sia�ea: t0� U�p8RR18Dt US
Date
o��� � �5;
�/P �te�� I�CD APR 2�� 2008
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uch as large print, Braille or on a tape. To request, call 1-Sa
or