P - 75532c� c oc�3at
iNinnesota Department of Labor and Industry
443 Lafayette Ro,�c1 North
St. Paul, MN 5y5�155-4342
Phone: (651 ' 84-5064
TfY/MRS: ;:. 1) 297-4198
wuvw.ele ity.state.mn.us
Co actor Re uest for Electrical I
Date Rough-In Inspeetion Required?
07/17/2008 Contractor Must Schedule All Rou I
Address of Inspection — Street
5691 WEST BAVARIAN PASS
ELAINE BELLOW
Owner Telephone Number(s) —
(763) 571-2484
CENTERPOINT ENERGY
757-6202
�or Authorized
New Dwelling Service/Power
Yes
— One Famil Dwellin /Associated Structure
Single Inspection Other Than Rough-In: � Ready Now
Contractor Must Schedule All Final Ins ections n Will Schedule
City/Tovmship County
FRIDLEY ANOKA
Project Description �v
WIRE/ RECONNECT AIR COND'F�t�
7
9320 EVERGREEN BLVD NW SUITE B COON RAPIDS, MN 55433
Contractor E-mail Address Electrical Utilitv
�oann.zinKenLc:enter�omttnergy
Contractor License Number
CA01796
Fee Calculation
or Assoclated Structure
Supply — ere @ $35
New Dwelling Service/Power Supply 401 — 800 ampere @$60
New Dwelling Fe�e�s/Circuits
New Home —
1 Feeders/Circuits - $100
cuits (in addition to
To 200 A Ca� $6 Each
Detached Garage or Other Associated Structure
New Senrice/Power Supply 0— 400 ampere @$35
New Feeders/Circuits ( ) @ $6 Each
Job�Project Gontact Person
JOANN ZINKEN
Existing Home/Structure Remodel or Additton
New Senrice/Power Supply 0— 400 ampere @$35
New Service/Power Supply 401 — S00 ampere @$60
RtewlE�nded Feeders/Circuits — Up to 15 Feeders/Circu�s
(_ ) Feeders/Circuits @$6 Each or 16 to 30 $100
New/Extended Feeders/Circuits — More Than 30 Feeders/Circu'r
( 1 Feeders/Circuits U� to 200 A fa� �6 Each
( 1 ) Feeders/Circuits $2 Each I $2
Detached Garage or Other Associated Structure
New Service/Power Supply 0— 400 ampere @$35
New/Extended Feeders/Circui� ( ) @ $6 Each
Reconnected Feeders/Circuits ( ) � $2 Each
TOWI (the fee calculated above or $35 multiplied TOtal (the fee calculated above or $35 multiplied
by the number of required inspection trips, by the number of required inspection trips, �f 3s s-d
whichever is greater) whichever is greater)
Requests for Electrlcal Inspeetlon (REI) wtth a fee of $250 or less explre 12 months from the flling date. The contractor must have the work completed withln
the 12 month period or submtt another REI that Includes the 1ns�cUon fee for the uncompleted work. InspecUon fees do not carry over from one REI to
' another. •
A servlce charge of $30 will be added f II dtshonored checks.
I hereby certiTy that I inspeded the electrical installation herein on the dates stated: For Depertment Use Only
Rough — In Inspection(s) Date �q �, F
Final Inspection I
� � ����_ �
Thts materlal can be made available In differerrt forms, ch
TDD (651) 297-4198.
REI 02 (6/07) �
�� ��`� r
RE�D J U L�� 200g
or on a tape. To request, call 1-80(
or