P - 76637q REQUEST FOR ELECTRICAL INSPECTION �
1- 9 9�� 3 2 9°� Minnesota Board of Electricity �- ' .;�
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
,.f���$LE (651)642-0800TTY/MRS 1-800-627-3529 www.electricity.state.mn.us
DescribA�using the back of the white copy if necessary - the work covered by this request:
New Dverhead 200 amp service residential
GENERAL FEES Outdoor Li hting Standard @$1
SERVICES / POWER SUPPLIES Traffic Si nal Standard $5
0 to 400 Ampere $8St Sup lemental Fee @$20
401 to 800 Am re $50 Transformers u to 10 KVA $10
Above 800 Ampere (�D $75 Transformers over 10 KVA (� $ 20
Above 200 Ampere @$10
2M, COMMUNICATION, REMOTE CONTROL,
:UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aaoaratus C�D $.50
Adddional Unit @
OTHER ADDITIONAL FEES
L'ghting Retrofit @ $.25 per Fixture
Center Pivot Irtigation Boom C�D $40
S cial Ins ion $.31 per Mile
THIS INSTALLATION MAY BE ORDERED DISC�
►IIII II III II III II III II I I II III II Ili II III �� I�f
19923291
Includes the Service and/or Power Supply up to 500 Amperes, All
Circ�its and Two Inspection Trips Each Dwelling Unit @$80
Additional Inspection Trips @ $20
Investigative Fee
Reinspection Fee (o� $20
total fee is $20) � $ 3 0. 50
I inspected the electrical inslallatian described herein an the dates stated: �
INECTED IF NOT COMPLETED WITHIN 12
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Date: Rou h-in Ins on R uired?
g pecti eq ❑ Yes � No Inspection Other Than Rough-In: � Ready Now � Will Call
6/ 21 / 06 You must call the inspector when ready! Date Ready:
I certi(y that I am the Q LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
Job Site SVeet Address ��y
6737 Washin�ton St. NE F,-;,��A��
Owner/Occupant Name
Mark Gabel
Eledrical Utility EI
Xcel Energy
Contractor / Company Name
Heights Electr�c, Inc.
Mailing Address (ConVactor, Company or Owner Perfoi
704 - 40th Avenue NE
i vcu��- �--
INSTRUCTIONS ON BACK OF YELLOW C
Fire No. County �
Anoka
Please Provide Two (2) Phone Numbers Including Area Co
(763 � 5 7 2-9113 � 612 � 281-209 7
;rical Ufilrty Address
Mpls
ConVador License Number Master ElecVidan or Power Limited Technician
CA0008 z 7 License Number
ng Installatian)
ol. H ts MN 55421
istallatlon) Please Provide Two (2) Phone Numbers Including Area Code
� 763� 788-8888 � )
BOARD OF ELECTRIGN COPY FRl10fNHA_15 a � �nna