P - 80498REQUEST FOR ELECTRICAL INSPECTION
, ' J I � � O � � ¢� Minnesota Board of Electricity ° �,
1-1 � � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� �, � (651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. state. mn. us
Identity the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
0 to 400 Am ere �$25
401 to S00 Am ere �$50
Above 800 Am ere � $75
CIRCUITS I FEEDERS
0 to 200 Am re �$5
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or ratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Waterheater
Outdoor Li htin Standard � $1
TraHic Si nal Standard � $5
Su lemental Fee � $20
Transiortners u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su I for Si ns I Outline Li hli �$5
ONE & 1W0 FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
.ING Circuits and Two Inspection Trips Each Dwellin Unit �$80
Additional Ins ection Tri s�$20
InvesHaative Fee
total fee is $20) I 20. 50I
OTHER ADDITIO JCf/� L- �S "�Z
Retrofit � $25 er Fi�ure �vH � p -/O - n �
'ivot Irri ation Boom � $40
�ured Home Park Lots �$25 I herebv certiN that I inspected the elecirical ir�stallation descr�ed herein on
S ecial Ins ' n�$30 r Hour '""`�"`" s�L
Special Inspection � $.31 per MMil�e �_� �`z—� �`� �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
FOR OFFICE USE ONLY
I llllll I1111 IIIII Illll Illll lllll Illll ll�ll llll INI
�E 1 1 2 6 D 9 7 3�f ��� ��(�
Request Date: Rough-in Inspection Required? ❑ Yes o Inspection Other Than Rough-In: Ready Now � Will Call
9-25-01 yW must call the i
nspector when reaqy! Date Ready;
I certiry that I am the [�LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of tlie electrical work at:
Job Address (Strcet, Box, or Route No.) Ciry Tap Code
5685 W Bavarian Pass Fridley MN 55432
Section Township � ange Flre No. County
O�upaM Phone
Barb Hovey 763-571-9691
Power Supplier Address
Electrical Contractor / Company Name Contrector License Number Master License Number
Total Electric Inc. CA02749
Mailing Address (CoMractor, Company or Owner Perfortning Installafion)
119 Eldorado NE Blaine MN 55449
Authoriz gnaNre r ortnin lation) _---� Phone
763-786-8484
EB -13 7/i/2000 � BOAND � ELEC7RICITY COPY RISTRUCTIONS ON BACK OF YELLOW COPY