1579 Cliff Rd - Electrical PermitsI) II II III I I I III I I III I IIII II
*03523073*
REQUEST FOR ELECTRICAL INSPECTION 96?
Mmnesota State Board of Elec(ricdy
1821 University Ave., Rm 5-128, St Paul, MN 55104 ?
Phone (612) 642-0800 ??o 4 ?'^.,?•
Home Duplex Apt Bldg. Other New Addn
Commercial Industrial Farm Remod Repav
Air Cond. H[g Equip Water Htr. Load Mgmt Other
Dryer Range Elec. Heat emp. Service
"X" above the wak covered by thrs request Enter remarks m fhk space antl on the back ot the whrte copy onty.
wired caS Pump C.11cmievve.r
Calcu/afe Inspechon Fee - Thls Nspecbw Request will nol be accepted wRhout the Covecf fee'
Other Fee ? Service Entrance Sire Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps _ 0? 700 Amps
Street Ltg./Traffic Sig Above 200_Amps , ! A6ove Amps
TransformeNGenerator INSPECTOR'SUSEONLY TOTAL
SigNOutline Ltg Xfmr 1? Q
Alarm/Remote Control
Swimming Pool I hereby cerlify tM1 I inspected , ncal mstallahon tlescribetl herein on iM1e tla[es statetl
Irnga6on Boom aoupn-m - oa?e
Special Ins
ection
p
Investigative Fee
Fnal V6W- Da??
THIS INSTALLATION MAV BE ORDERED DI CONNECT IF NOT COMPLETED WITHIN 18 O THS.
OFFlCE USE ONLY This reQUest mid 10 months hom valdaLOn date pnnted in this box
352-307 [81
9?o19(00
PLEASE PRINT OR TVPE
RepUest Oata
?
?? -% liouqh-in ms echon re ?
p qwmtl ? Yes o
V
t
Inepection Othlr TMdn Rough-In R atly N. 0 Will Call
, (
au mus
call the inspectnr when reatly) Date Reatly .
I, A licensed coniracror ? owner hereby requesl inspection of the above electncal work at
Job /ultlress [Straet. 8w, or Roule No )
Is7 I" -F d Ctly
Ea n Zip Cafo
ss/a?
S?.r.tion No T wnship Name a No Rargc No Fre N. Cwnl
aKo?u
Occupant ?
S tkU 01 PMnc No
Powea Supplier AAtlress
Elaclncal Cqntraclor (COmparry Name)
T Ele? ic V ?u, Tn( - Goniraclor License No
(, CX Mester Lic No (Fant Eleot Only)
Mail n9 Atl(Iress ?COMr2dor or ripr Pertaming Installahon)
?? I ? ?O?
Authonz SgnaWm (CO r or wner P Aorrppng InetellaLOn)
? PhoitB No
aao ??I? ?- ?1?9
EB-06031A-11 8195 $TATE BOARD COPV - SEE INSTFUCTIONS ON BACK OP VELLOW COPY
This request rold (?y?/
18 nwnths fmm 'y?/O U O
C? 4570i:,?,3/ ?s (]?IL.
Ne.quesl Date l
?? /+/
l
? Fire No. HouPh-in InsVecuon
Re
quiretl?
ReaOV Now Q W, II Nobiv Insper.-
I
Wh
R
p
y ?,j ?
Ves No or
en
eadY
lncensetl Electncal ConVactor I hereby request inspection oi above
Owner eleGneal work mstalletl at=
Sveet Address, eox or Noute No. 7?
n
? Citv
?
/
/= I?-WQ ?Ti?/f!
e<Unn o. Township Nome or Nu. Hange No. County
?GJ
Ocr.upa PPINTI ,
? Phone No,
O S)5(?
Power SuO?her
?
? Adtlress Q.. a
.
I
0 TA-
. ?iqi2/?/•v? o.d SSOo]
EleGncal ConVactor ICOmpany Namel Coniracmr's License No.
Collins Electrical Const. Co. 0395-47-2
Mailine AdJ,ess (COntractor or Owne, Making Instailat.onl
278 State Street St. Paul, M 55107
Au Signature ra d0 er Makmg InstallaLonl Phnne Nunibvr
(612)224-283
THIS INSPECTION REQUEST WILL NOT
MINNESOTq STATE BOAND OF ELECT ITY
Gngge-Mitlwey Blde. - Noom N-197 BE ACCEPTEO BY THE STATE BOAFD
UNLESS PFOPEH INSPECTION FEE IS
1821 Universrtv Ave.. St Vnul, MN 55704 ENCLOSEO.
Phone (672) 662-0800
HEQUEST FOR ELECTRICAL INSPECTION es-ooooi-os
0 See ms4vcLOns tor comolapng [his torm on Eack ol Vellow copv.
E 45703 "X" 8elow Work Covered by 7his Reques7 G1 J ?i??J'
i
A of Bwltlhng ApOlmncea Wned EquiVmenl Wve?l
Range Tenq?orary Service
x Water Heater LiyhUny Fiztures
R ewlAing
Apt Dryer EleCtric Heatn?c
ercial Bldy Fumace Silo Unlonder
tnal Bldg Air Condinoner Bulk Milk Tank
Otnr.r cee.ry Oihee
Suecifv Ner pihe,
ompute Inspectrun Fee Beluw
p Fee ServmeEMrence5ixe n Fae Faeders/Subieeders a n Cir uits
0 to 200 qm s 0 to 30 qm s 0 to 30 Am s
Above 200 qn)py 31 to 700 Amps 31 to 100 Amps
Swimmfny Poal Above 100-Ain s Ahove 100_Am»
Transtormers IrrigaLOn dooms Parnal,'Other Fee
Signs SVecial inspectron S S
Aemarks ?
TAL EE,?/
!
flouph-in Date
?, ?ha E ctr I
Inspector, ?aby
d
h
Final ? D:?te cer?
y t
x[ Ihe ahove
,?? QI msvecbon has eeen
a
I a.
ma
Thinrequestvoi0lBmontMfmm ?'?
60 V?6 ??14, -2y
Requesc Dale Frre No Rough-,n Inspection
Reqwretl?
? Reatly Now.^/ill Notdy Inspector
When Reatly?
Yes o
IN-<,censed contractor 13 owner hereby request mspection of above electrical work at:
Job AOtliess IS!reet Box or Roule No 1
( cJ 1 G l
o o? ? CM ?
a oi Vi
Secoo, No TowTship Name or N. Ranqe No Counly
tDa k o?
OcwpantlPRINT? Phone No
O, a GO
aower Soooler Aaaress
Elecinral Conlractor iCOmpany Name) ,
e?
I b
j
6
G Conlraclors Liaense No
b oS o
00
.
MaJing Atltlress IGonVacbr or Owner Mahinq
Z 8 S?_S Inslallotion
S{'. ? u I
Yvl N SS ? o
Aut?onteo SiSn#.rte ?CO?hacto• Owner MaW
?D L I I ) Wa_P_., nS Inslallaliorq
i ik-k?c,
_ Pnone Number
2
24 -Z$
MINNESOTA STATE BOABD OF ELECTRICIYY + THIS INSPEGTION REOUEST WILL NOT
N
Griggs-MlEway Blag - Room 5493 616 ?` BE ACCEPTED BY THE STATE 90ARD
?
1821 University Ave, St Paul. MN 55104 G ?? UNLE$$ PROPEF INSPECTION FEE IS
Vnone(612)64Y-O800 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION
o1315
ii?
ji? $BB i?911?(.?IO?610rOOII1?)10???91M1i810f1n Od baCk 0f }'BIIOW OOpy L'Yl."??
?( ,{
E07765 `X" Below Work Covered by This Request
Newi-Atld fi 7ypeofBuildmg AppliancesWiretl EquipmeniWrtetl
T ome Range TempOrary ServiCe
uplea Water Heater Electric Heahng
Bmlding
Apt Dryer Other (Specdy)
Comm /Indushial Furnace
Farm Au Condihoner
Ornerlscenlyi
Compute Inspechon Fee Befow Connactor's Remarks
AJ d S ne t? Govoktv"
G1 vi ,-ts
? k Other Fee # ServiceEntranceSrze I Fee # Qrcutls/Feeders Fee
? Swimming Pool ' 0 to 200 Amps 0 to 100 Amps -
Transbrmers Above 200 _ Amps Above 100 Amps
Si9ns Inspecmr's Use Oaly T TAL U
Irngauon Booms ZQ
I Special Inspecbon
Alarm/Communicahon THIS INSTALLATION MAY BE ORD ISCONNECTEO IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
1. Ihe Elecincal Inspector, hereby
certrt
that the ab
t
h R°°qn'" oaie
y
ove inspec
ion
as
been made
?????
OFFICE IISE ONLY
TM1is re0ues[ voio 18 mon1M1S irom '
E 83536
1
? ?
iliL?-?-C7 ?-C,('
Reques[Date .
Fire No
'_ ?J CYO
0? ?7 Rqgh-m Inspgqnn ?'?
Required'+ gf?eatly Naw ? WII NoOfy Inspector
?
O ? Yes ? N.
When Featly7
Iicensed contractor ? owner hereby request inspection of a6ove electrwal work at:
bb Ad ss Sireet, Box or
Fioute No.) CM
Cv '
/5
i No. ownship Name or No. Pange No rq??y
?
Occupant (PRINT) Phone No.
•
? _ V ??
ower Supplier AEtlress
Elep I CoMr or (COmpa Name) Connrecbr5 ?rens¢ Np
'- c- D
g Atltlress (COmractor a r Meking In IlatOn)
lwlMriz Si Wre (CaMradwiVwner al o Phona Number
ry
M ESOTA STATE BOARD OF CTqICITY
Grigga-Mitlway Bldg. - Room S173
1011 Univeretty Ave., St. Pauy MN 55104
Phone (612) 612-0800
THIS INSPEGTION REOUEST WILL NOT
BE ACCEPTED BYTHE STATE BOARD
UNLESS PROPEF INSPECTION FEE IS
ENClOSEO
? REQUEST FOR ELECTRICAL INSPECTION ea-o oio7
" ? See In3tmclions for compleLng ihla lorm on back oi yellow cupy, Y' y?
Jn 3 6 `7C" Below Work Covered by This ReQuest
ew Atld Rep. Type of Building AppliancesWiratl EqwpmentWiretl
Home Range Temporary Service
Duplex Water Heater Electric Heahng
Apt Bwlding Dryer Other (Specity)
Comm./Industrial Furnace
Farm ' Air Conditioner
Olher (spectly)
Compute lnspecfron Fee Below: Co ractor5 Rema
# Other
Swimming Pool Fee # ServiceEniranceSrze Fee # Circuits/Feeders p¢e
Transformers 0 to 200 Amps 0 to 100 Ames
Si ns
9 Above 200 _ Amps ve 1p0 _ Am s
P
insp¢c?orS U. Ony. TAL
IRIJ2t10f1 8Op(pS
Special Inspection
Alarm/Communication
Other Fee
I, the Electrical Inspector, hereby Rougn-m Date
certify ihat the above inspection has
been made, F,nei
at
DFFlCE USE ONLY
i
rhis raques voltl 18 months irom
J
e/. ?? REQUEST FOR ELECTRICAL INSPECTION ee-oao2m-o`V??
/ ? See insvuclions fw wmpleong this brm on back af yellow copy , 95 d J
rei' Cf t-7 !1 1 16v" ui.,.4 r.nvcrad hv This Reauest
Lc? i U I J'L ••
i VV•V•. ..V... --'-?' E Ui meniWired
AppliancesWired 4 P
e Add Rep. ng
TypeotBuiltl Temporary Service
Home Range
Water Heafer Electnc HeaUng
Duplez Other (Specity)
Apt Buddmg Dryer
CommJlndustrial Fumace
Farm Air Conddioner
Other (specity) Contractor5 FemeMs
v ?R?Ol.i1J? ISLAt??S
1JE?.
Compute Inspection Fee Below:
Fee
q Other Fee # ServiceEntrenceSrze Fee # CircmGSlFeeders i
A
Swimminq Pool mps .
0 to 200 Amps 0 to 100
Transtormers Above 200 _ Amps Above 100 _ Amps
Signs
Inspeaor5 Use Only TOTAL
Imigation 8ooms
Special Inspection
AlarmlCommunication
L Other Fee • oate
Rough-in Tok
ihe Electrical Inspector, hereby
I
,
certify that the above inspection has F„al Dale 1 7
been made. ,
OFFICE USE ONLY -
This requesl vod 16 manihs fmm $1 w.,
?
'?? C;,'
?y`I`/I?J
q
[
? .J 0 7 0 1 4. ?g 131
Request Dale ' Fire No. Rough-In Inspeqnn
Req?B5tl7 M Reddy Neer idWili NMiy Inspec[w
Y?When Featly+
? Na
rQ?
I?licensed contractor ? owner hereby request inspection of above electrical work at:
JOb AGtlre9s (SVeet, Bov or Routa No ) CiN
a all)
r
15'I q O-L«r zoR)b r-
Sechon No. Township Nama or No. Range No Counly
1ja,?A
P?one No.
Occupant (PRIM)
?
p uppber Address '
Elecmcal Convac[or (COmperry Name1
qor§ Licanse No
Contra
,
MaAing Atl (CoMrador or O.vner Makng Installalion)
Asqnatu,.rr,
(ConiraclorlOw bng In^sWllaOOn) ..., t 1 ?)10[1 .XA Pho umber
w ? - -
THIS INSPECTION FEQUEST WILL NOT
MINNESOTR STATE BOAND OF ELECTRICITY gE ACCEPTED BV THE STATE BOARD
Griggs-Mitlway 6Wg. - Ream S173 UNLESS PROPER INSPECTION FEE IS
1821 UnlvBraity Ave., SL Paul, MN 55104 ENCLOSED
Phone (812), 842-0800
,
?rcy
Repuest DaM
G?/? ? ire No Rough-In Inpsedqn RepmreC
(VOU muat ca9 mspeclmwhen reatly) InsOecbon Othe, Than Rough-In
14 qeatly Now ? Will Noti InsOectar
? Ves No DeteReaOy
I;FL licensed contractor ] owner hereby request inspechon of above electrical work at.
Job 4?dress (Streei Box or Routa Na ) Dery
s 74' 6iss Ro.vo E??r.4nJ
S7o Towns? Nip Name or No qange Np Counry
- ??'O TiTf
Occupant(PAINT) Phone No
T x.a- C-e .s ??.? r.n~s
Power Supplier 1
I HtlErass
Eiettr¢al Convactar lCompany Namel ConVemorS Licensa No
G.
MaAmg Atldrses IConttactor or Owner Makrng Instailetion)
/.z VG 4 _onJ£ A&Ie.
Ambonaed SigraWre i omrecw,wner Ma.iog Inseliation) PM1One Numbar
- & zf - ,4 " _ 'Ofo -3 SS?
MINNESOT(STATE BDARO DF ELECTRICITV THIS INSPECTION REOUEST WILL NOT
GngBe-Midway Bltlg. - Room 5-171
6E ACCEPTEO BV THE STATE BOARD
t611 Univereity Ave, S, Paul, MN 55104
UNLESS PFO
Phane(6t2)5C2-0800 PER INSPECTION FEE IS
ENCLOSED
Z'?G0?9 REQUEST FOR ELECTRICAL INSPECTION ?,ha""''tis EB-0/0
001C-
08
Sea inSTmtlions lor compieuny this lorm on back ot yellow copy
p r?q
4 5 7 G 1?'I/y'?jL "X" Below Work Covered by This Request
C?1 n
/
"??:?•? '?(p
ew Add Rep I TyDeoiBmlding ApphancesWired EqwpmentWiretl ?
Home Range Temporary ServiCe
Duplex Wa[er Heater Electric Heating
Apt Building Dryer Load Manegement
Comm./Industnal Furnace Other (Specity)
Farm Au Condi6oner
Otheilsl conlraclorsRemarks xOUE ?? ???ff??(Je
Compute Inspection Fee Below: ?• rN3Tq44 XfoLATfO 67809411
# Other Fee # ServiCeEntranceSrze Fee # CucuRS/Feetlers Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 - Amps Above 100 _ Amps
Signs , Inspectors Use Ony ?--?
.
? TOTAL A&/
Irnganon Booms ?
?
?
( SpeCial Inspection
Alarm/Communicatwn SCONNECTED IF NOT
THIS INSTALLATION MAY BE D DI
Other Fee e ,jup,CJ/ COMPLETED WRHIN 18 MONTHS.
1, the Electncal Inspector, hereby ROll oaie
Certify that the above mspection has
been made Final oa?e
OFFICE USE ONLY +
Tnis reQuest voitl t8 monlbs trom
II?IIIIII I I II I`I III REDUEST FOR ELECTRICAL INSPECTION
MinnesWa State 8oard of Electricity
- 2, S. Paul, MN 55104
1821 University Ave., Rm. S t
* 0 3', " 3 7 8 7* phone (e12) 642-0e00 ?J.3
Home
Duplez
Apt. Bldg.
Ofher.
New Add
n
Commercial Industrial Form Remod Re air
Air Cand. Hig. Equip. Water Hir. Load Mgm}. Ofher
Dryer Ran e Elec. Heat Tem . Service
"X" obave ihe work covered 6y ihis request Enfer remarks mthrs space ond on the back o9 the whi}e mpy only.
C@Qiace. C? w ASh ? e?...?`?+Men#
?
Calculate Inspedion Fee - 7his Inspecfion Requesf will na} be accep}ed withaut the comecf fee:
Other Fee # $ervice EMrance Sire Fee # Circvih/Feeders Fee
Mobile Home Pork $tall 0 to 200 Amps O to 700 Amps aa?-
5}ree} Lfg /iraHic Sig. Above 200 Amps o 0 Amps
Transformer/Generofor INSPECTOR'S USE ONLY TOTAL
O
S
Sign/Ouiline L}g. Xfmc a a?
Alarm/Remote Confrol
Swimming Pool I hereb cedd rhor I - ecred ihe eleckiml msMllofion descnbed heram on Iha dolea abfed
Irrigation Boom poogh-in Dme
$peaal Ins
edion
p
Investigatrve fee F'roi oane ' 4
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
318 m3 (Q
? OFFIC`c UqqTT?F ONLY Thu r qaest void 18months imm voLdalmn dote pnnkdihis box?/
C/_ Y(%/
.co
?
PLEASE PRINT OR TYPE ),J K,' DC
Reqoesl0ate Rough-m mspecTOn reqmred2 ? Ye: ?$.No Inspecnon OrherThon Rough-In [] Ready Now?',?^ Will Call
?You mus? mll ihe inspenor when ready? ?ote Reody
I, 0 L<er.sed controdor ? owner hereby requesi inspedion of the above eledriml work at-
Jab Addrees (Slreet, Box, or Rame No ) Gry Zip Code
(
1 dSl 1'-Oj A?
Senion No. Township Nome or N. Range No Fra N. Caunly 1
IDA, {(A+'
Ou.pa. f Phone No
'?Exw co
PowerSuppLer Address
Elednml Commcwr ICompany Nomej Contmcwr Liwnse N. MI Lc N. (Plom Elen Only)
Maili Addres/s?(ConhacmrorP\nnerPedormin9lneMlla?h(o?n)?
AuMonredSigmWre(ConlmdororOwnerP sbllahonl PhoneNo
EB-00001A10 6/95 STATEBO COPY-SEEINSTRVCTIONSONBACKOFYEILOWCOPY
?? ?
p 0 806 5 IT / /
,,,„? 4
1 ?
-%-go 0V
Request Date Fne Na Rough-in Inspecimn
I Reqmred' ;K9,eatly Now ? WII Nobty Inspector
? Yes o N1hen Ready9
I licensed contractor ? owner hereby request inspection of above electrical work at:
Job Atltlress (Street, 6m w ou qry
C
[ LJ
Secllon No. Township Name or No Range No. County
Occup/an{(PRINT)
? Phone No
J ?
?C .??1.. `I
Pow r Supplier Adtlress
ElecfncalC Vactor (Cq pany Name) Con[ractor5 Licensg No
Mailing Address (Comramor or Owner Mak I tellation)
7
ed S?gna ( Vaclor/Owner Making I nslallatwn) Phon
e
Number
` '
!
/ 7^
/ ?1KO
MINNESOTA STATE 60ARD OF ELEGTi11CITV
GriggsMidway Bitlg. - poom &173
1821 University Ave , SL Paul, MN 551 W
Pho. I6121642-0e00
REQUEST FOR ELECTRICAL MSPECTION
? See mshuaions for compteLng ihis form cn back ot yellrnv co
THIS INSPECTION REQUEST WILL NOT
6E ACCEPTEO 6YTHE ST.4TE BOAFD
UNLESS PROPER INSPECTION FEE IS
ENCLOSEO
2 PY
U' -0 4RQ 6 "X" Selow Work Covered by This Request
I
0 EB-00001-07
9,--) -3 o-?)
w nvo nep. Iypep}yUpdin_q qppliaxesWired Equ'rpmen[Wired
Home ange Temporary Service
Duplex ater Heater Eledric Heating
Apt guilding l ryer Other (Specrfy)
Comm./Industrial urnace
F
arm Condrtioner
Air
Other (sp¢py) Conhactor's Remarks '
Compute fnspeciion Fee Below: p
Q
?
# Other Fee # ServiceEnlranceSrze Fee # Qrcutls/Feeders / Fee
Swimminq Pool 0[0 200 Amps 0 to 100 Amps
Transtormers Above 200 _ Amps Above 100 _ qmps
Signs InspecMr§ lJSe Only. TOT
Irrigation Booms AL
Special Inspeciion
Alarm/COmmunication ?
90 i ? Q
Other Fee
R
I, the Electncal Inspector, hereby
certdy that the above ins
ectio
h OUgh-in
p
n
as
6een made.
F?nai
oa?=
)FFl-- USE ONLV request voitl 18 months }rom
This renuest void ?/3/9r?
79 mortthsp trom /?i 0O 80 3 0 ! ri ?/ 14d
.lh?.Ll) .? .fSo ?Ifi
90 061 7
Request Date ' Fre No. qoueh-in InsuccLOn
Faq irad?
?Rpady Now?Will Nobty InsPec-
?C? Ves ?NO r?or When Reatly
Lroensed Electncal ConVactor I hareby request mspect{on of ebova
? Owner elechical work installed ac
Street Address, 9ox or Route No. Ciiy
A*, ?? '0fj
eciion o. Township Name or Nn Hange N. County??
Occupant(PRINT) Phone No.
D C u m 41-1'
Power Supplier
/? S f ° Address f,?.,
X 4c?? :::?-
Electncal ConVactor ICompany Namel
Collins Electrical Const. Co. Conhac1or"s Lmense No.
0395-47-2
Mailiny AAdress (Cont actor or Dwner Makme lnstailauon)
278 State Street St. Paul, M[>I 55107
Auth zed 5? ture IContr /O r M i g Installationl Phone Numbrr
(612)224-2833
MINNESOTA STATE BOAflD OF ELECTFICITY THIS INSPECTION flEQUEST WILL NOT
Griggs-Midwav Bldg. - Noom N•191 gE ACCEPTED BV TNE STATE 90ARD
1821 Univareily Ave., St. Paul, MN 55104 UNLESS PpOPEFl INSPECTION FEE IS
Phone 1612) 297-2111 ENCLOSED.
fJ?3lN _ REQUEST FOR ELECTRICAL INSPECTION s-oooo/i.onry
See instrucluoes for comple4ng this form an back o( yellow copy.
?08030 /(?
"X'" Below ork Covered by 7his Request L10`0
Ntnx AAtl Nep. TyOe ot Builtlmg Apoliances Woetl Eqmpment Wved
Home Range Temporaiy Service
Duplex Water Heater Lightiny Fixtures
Apt. Building Dryer Electnc Heatin
Commercial Bldg. Fumace Silo Unioader
indusnial Bldg. Air ConAiLOner Bulk Nhik Tanic
fBfm Othai PeoEY Other l5uacify)
t er Suec? y Other Other
Comauie lnsoectlan hee Helow
# Fee ServiceEnlraneaSize k Fae Feeders/Subfeeders k Fee Cucuits
to20 m s 0 to30Am s 0 to30Am s
Above 0 qmpy 31 to 100 Arnps 31 to 100 Am s
Swimminc? Pool Above 100-Amps Above 100_Am s
Transiormers irri ation Booms Partial. Other_F
Signs Speciallnspection $ T
Rernarks FEL?
? /il .l1v
Rough-in ? ?a?e/ I, the amnc
?
? /!,.° Inspacto , erahy
^ ? cartily that tha above
Final g+? te
? nspaetton has been
• f
" ? ? made.
iue mnueeI unid 1 P mnMhn 4om
_ 602915 ? ? ZI2(?V
(0 3 8 3 91 F,e N 9h.,n in=Pedion
Request Date qeqwretl' eatly Now ?il„eNoOP ansP?oa
2 _ p M Yes No
I r censed contr tor ? owner hereby request inspedion of above electrical work at.
ciry ?
ob Addra 1 el, o r Roure No
K ?
Gbunl 40,
SecOan No Tawoship Neme or N. Range N.
Phone No
OGCUpant(P T)
C (1 s.?f' n,./1
Address
Power Suppli
? Gonirnaor5 License No ?
Elecinc Gon rJCtor ?GomPeny Nam D ? i
Maihng Atltlress? IConVactor or Owner Me0.mg I tallavoN ? ss? 0
. I
? PhoneNumber
Authon=etl aWre 1COOtrac?o??Ow a'+ing Installavon)
? ?
THIS INSPEGTION RE4UEST WILL NOT
MINNESOTA STATE BDAPO OF ELECTRI ITY gE ACCEPTED 8Y THE STATE BOAFD
Grlggs-MlAway Bldg. - Aoom 5?113 UNLESS PFOPER INSPECTION FEE IS
1821 University Ave, St Paul. MN 551119 ENGLOSED
Phone (612) 692-0800
REQUEST FOR ELECTRICAL INSPECTION r";hr-" ; E-oo m-o7 ?
? ? See insUUCtions lor compleliog lhis torm on back oi yellow oopy
?
?
X" 8elow Work Covered by This Request
38391
A hancesWired EqwpmentWired
ew Atld- Rep' TypeofBwlding PP Temporary Service
Home Range
Duplex Water Heater Elecinc Heating
Apt. Bmlding Dryer Other (Specify)
Commllndustnal Fumace
Farm Air Condrtioner
O r (specily.) ' Coniractor3 Remarks cl/O?
.S W? tl
?
Compute lnspec6on Fee Below.
g Other Fee # ServiceEntranoeSZe Fee # Oto CircultsIFeeders Fee
Swimming Pool 0 ta 200 Amps
Transformers A6ove 200 _ Amps 0_ Amps
rornL ?
$ICJnS Inspeclor's Use Only
U ?
Irnganon Booms
Special Inspection
AlarmlCOmmu hon THIS INSTALLATION MAY 6E OHDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS. oaie
Roug?-in
I, the Eledncal Ins ctor, hereby ^7?
cerirfy that the above mspection has F,,,ai ",y ^
been made.
OFFICE USE ONLY
This request void 18 montM1S Imm