P - 75174Minnesota De
443 Lafayette
St. Paul, MN
Phone: (651)
TTY/MRS: (6
�nt of Labor and Industry
North
{ 297-4198
tate.mn.us
Contractor/Registered
Date Rough-In Inspection Required7
4/23/8 Contractor/Employer Must Schedule All R<
Address of Inspection — Street
5650 W BAVARIAN PASS
Owner Name
BARWICK
Owner Telephone Number(s) — Include Area Code(s)
ContractoNRegistered Employer Name
CITY VIEW ELECTRIC,INC.
ContractodEmplover Telephone Numb�
(651) 659-9496
Yes
uest for Electrical I
er i nan nougn-m: U Ready Now
Must Schedule All Final Insoections ❑✓ Will Schedule
FRIDLEY I ANOKA
Project Description
PO 49440 ROBERT CLAUSON (651)777-7885 INSTALL
SUBPANEL, REWIRE BATH - ADD FAN 8� MISC.
(WHIRLPOOL)
1145 SNELLING AVENUE NORTH, ST. PAUL, MN 551108
Contractor/Employer E-mail Address Electrical Utility
nature Contractor License Number
n CA00384
Fee Calculation
Service/Power Supply 0— 400 ampere @$35
Service/Power Supply 401 — 800 ampere @$60
Servics/Power Supply Above 800 ampere @$100
New/Extended Feeders/Circuits Up To 200 A( 4)@$6 Each
Feeders/Circuits Above 200 A ( )@$15 Each
Reconnected Feeders/Circuits ( ) @ $2 Each
Manufactured Home Park Lot Supply ( )@$35 Each
Job/Project Contact Person
GALEN STICKFORT
Technology System Devices (
Center Pivot Irrigation Booms (
Plus ( _ ) Electrical
Luminaire Retrofit Modifications (
) @ 75¢ Each
) @ $35 Each
nit�@ $5 Es3ch--
) @ 25¢ Each
Concrete-Encased Electrode Inspection ( ) @ $35 Each
Investigative Fee $70 Or The Total Inspection Fee,
rws mnes m i ne iKS mnea e rcace or
Recreational Vehicle Site Supply Equipment Other
Circuits Ori inatin in the E ui ment $6 Each
SVeet, Parking Lot, Lightlng Standard ( )@$5 Each OVBf 6OO VOItS — Add tl�e combined aerviw/power euppty ami feeder/dreult fea ro
reault in double the reguler fee (does rrot epply to electric eign end ouUine Iightlng)
Transformers Up to 10 kva ( )@$15 Each � ) New Multi-Family Dwellings @$70 Each
With Up To 20 Feeders/Circuits
Transformers Over 10 kva ( )@$30 Each ( ) AddiUonal Circuits Above The 20 Allowed Per Unit
6 Each
Electric Signs and Outline Lightlng TOtel (the fee calculated above or $35 mulUplied
Transformers/Power Su lies $5 Each by the number of required inspection trips, $70.00
whichever is greater)
�
Requests for Electrical Inspectfon (REI) with a fee of $250 or less expire 12 months from the filing date. The contractor/employer must have the wor�
completed within the 12 month pertod or submit another REI that Includes the inspection fee for the uncompleted work. Inspection fees do not carry ove „/��
from one REI to another. �tJ
A service cha e of S30 will be added for all dishonored checks. �
I hereby certify that I inspected the electrical installation herein on the dates stated: For Department Use Only �
Rough — In Inspection s) � Date � � ��
�
This materlal can W
TDD (651) 297-4198.
REI 03 (6/07)
. _ 6J�8 aa� � s
"�t-�' REC'D APR 2�8 200�
� as large print, Brallle or on a tape. To request, call 1-500-342-5354
or