P - 75513Minnesota Depart ent of Labor and Industry
443 Lafayette Ro� North
St. Paul, MN 5 5-4342
Phone: (651) , ' -5064
TTY/MRS: ( ) 297-4198
www.electri .state.mn.us
� Contractor/Re istered Em
Date Rough-In Inspection Required?
09/12/08
/'1UUIC55 VI IIIS�JCGLIVtI - JUdCI
1501WNIDEMERE DRIVE
Owner Name
- Include Area Code(s)
contractodKegistered tmployer Name
JZ ELECTRIC
Contractor/Employer Telephone
(763) 545-2002
Service/Power Supply
Service/Power Supply
Service/Power Supply
h-I n I
��
Yes
uest for Electrical I
smgie inspecuon �tner i nan Rough-In:
ContractoNEm olo er Must Schedule Ail Final Inspe
City/Township County
FRIDLEY ANOKA
Project Description
PORCH REMODEL- IN FLOOR HEAT
c:ontractoriKegistered Employer Mailing Address
2525 NEVADA AVE N#104 GOLDEN VALLEY, MN 55427
Contraetor/Employer E-mail Address Electrical Utility
info@jzelectricinc.com
Contractor License Number Job/Project Contact Person
CA04070
Fee Calculation
0- 400 ampere @$35 Technology System Devices ( )@ 75¢ Each
401 - 800 ampere @$60 Separate Bonding Inspections for Swimming Pools and
E ui otential Planes $35 Each
Center Pivot Irrigation Booms ( )@$35 Each
Above 800 ampere @ $100
Plus � Electrical Drn�e Units $5 Each
New/Extended Feeders/Circuits Up To 200 A( )@$6 Each Luminaire Retrofit Modifications ( )@ 25¢ Each
Feeders/Circuits Above 200 A ( )@$15 Each Concrete-Encased Electrode Inspection ( )@$35 Each
Reconnected Feeders/Circuits
( )@$2 Each Investigative Fee $70 Or The Total Inspection Fee,
Whichever Is Greater U To $1,000 .
Manufactured Home Park Lot Supply ( )@$35 Each Special Inspection Fee ( ) Hours @$80 Per Hour
Plus ( ) Miles Caa)_ The IRS Mileaae Rate of ( 1
Ready Now
Will Schedule
Recreational Vehicle Site Supply Equip
( ) Circuits Originating in the Ec
Street, Parking Lot, Lighting Standard (
$6 Each
-- __ — - -- -- - - _ _ -- - -
)@$5 Each �V@� 6OO VO — Add the combined service/power supply and feededcircuit fee to
reault In double the repular fee (does not apply to electric sfgn end outline lighting)
Transformers Up to 10 kva ( )@$15 Each
With Up To 20 Feeders/Circuits
Transformers Over 10 kva ( )@$30 Each ( ) Additional Circuits Above The 20 Allowed Per Unit
6 Each
Electric Signs and Outline Lighting Total (the fee calculated above or $35 multiplied
Transformers/Power Su lies $5 Each by the number of required inspection trips,
whichever is greater) $70.00
Requests for Electrlcal InspecUon (REI) wlth a fee of $260 or less explre 12 months from the flling date. The contractor/employer must have the work
completed wlthln the 12 month perlod or submtt another REI that Includes the Inspection fee for the uncompleted work. Inspectlon fees do not carry over
from one REI to another.
A servlce char e of $30 wlll be added for all d(shonored checks.
I hereby certity that I inspected the electrical lnstallatlon herein on the dates stated: For Department Use Only
Rough - In Inspe 'on s) Date �� 0�� �yVl �'
/ � ��//�° - �� �� �J�
Final Inspect Date �C� ��� o�i 20��
C�--� ,�-=./ b �j�-r�
Th1s mate c n be made available in dlfferent forms, such as large print, Brallle or on a tape. To request, call 1-800-342-5354 (DIAL-DLI) Voice or
TDD (651) 297-4198.
OCI /19 /C/f17\