1305 Corporate Center Dr - Electrical PermitsThis repuesl void
18 months fmm
C 19194 /--3,,)
Requy?est Dated
J Gz O 7
Llcensed Eleclrical ConVactur
? Owner
7: 3, c 0 & :-?
iphe??InspecT?6n ?Ready Now Q Will Notity. InsPec-
[or When Ready
]Yes No
I hereby request las0ection ol above
elechical work ins(af lad at:
/ d1S L- ' eox o ,•???'.!? `?1 rc•-- •--f/
? oY• _r'.. ?
. ?i K VL
? r
J`
it
lecbon o. Townshi0 Name or No.
Ranqe No.
Co
1 -"
P ane No.
OccuGan (PRINT)
rij ? ,??/
Power Supplier Atldre
C?????raclo?'s Gcense No.
ElecnI Con acmr ICo? any Nemel
-- _.,
2:,
Mailin0 Address ICOnVactor or Ow r Making In a' tnl
"r, ? /? ?T•
4w
e Makiny Ilati I
Autho zed Signatur, IComr ior n r ?? ?be?
o,n f
[v
TH IS INSPECTION NEQUEST WIIL NOT
MINNESOTA STATE D OF ELECTflICITV
m N-191 '?1
H gE ACCEPTED BV THE STATE BOAAD
UNLESS PPOPEN INSPECTION FEE IS
oo
Griggs•Midwav Bld .
1821 UniversitV A .. St. Peul, MN 55104 ENClOSED.
Phone (612) 297-2111
51 -?VT7 REQUEST FOfl ELECTRICAL INSPECTION ee-ouooi.oa
1
ll
ow copv.
ve
? Ill, See instructions tor completing Yhis farm on back o
()1 0 A "Y" Relnw Work Covered by 7h is Request
' ?l .LJ 1 J?
O??ancea W?reC
A -
EquipmeN WireA
AAd Pap. TVpe ot BuilAing O i
S
?
Home Fange ce
erv
Temporary
Ouplex Water Heater Liqhtiny Fixtures
Apt Building Dryer Electrie Heatm
Commercial Bldy. Fumace Silo Unloader
Industrial BIAg. Air Conditioner Bulk Milk Tank
Farm Otnrr oeci y O?nar t5nectfvl
t er SVecify ther Oth?r u
nC.' _
Compute lnspec[ion ree uero -- Ko ? - _
k Fee Service EntranceSize R i e Faxders/5ubfeaders # Fee Circulns
U to 200 Am s 0 to 30 Am s 0 tn 30 Am. s
Above 200 Amps 31 to 100 AmPs 31 to 100 A s
c ...:......:.... o,,..i Ahnoe 100-Amps Above 100_AmP+
S
Final
fltla reyuest vold 18monthe
I the ElacTloal
InsGectar, nereby
certify that the abova
inspection has baen
made.
'+Z.
REQUEST FOR ELECTRICAL INSPECTION EB-00001-04
f ?
ip See inatructiona lar compiatmg ihis torm on beck of yellow eopy.
? 9.2718
X"" Below WQrk Cavered by This Request > t1°vv ? v
Add Rep. TYOe ot 8uildinp Aooliances WirsA EquiDment Wired
Home F1a,, ge Temporary Service ?
Duplex Water Heater Lightiny Fixtures
- Apt. Building er
?ry Electric
Heatin
Commercia{ Bldg. Fornace Sito Unloader ?
Industrial Bldg. Air Conditioner 8Wk Milk Tenk
Farm otner oeci v ??ner tSUOCIrv)
t er uecify Other ?
ompuie fnspectron fee Below - M Fee Service EntrancaSize q fee• Feedars?Subleeders # Fee Gircuite U to 200 Am s 0 to 30 qm s 0 tn 30 Am s
Above 20 mps 31 to 100 Amps 31 to 10Q A
Swimmin Poo Above 100-Am s Above 700_Amps
Traasformers krigat+on flooms ?>o Partial.'Other Fee
Signs Specia?lnspection S ?
v `
TOTA E
em?rks t?
??
{- . o U
Nough-in " (
t ?5 ??,?.? 1, tne eu1ce1
Inapeetor, e y
certiry that the above
Final { f? ?
? D^ e-?? insOeclion has heen
de.
tl)QmonNSirom
re¢uest vai
Tpie
L ?,3)`?i 4?i2- I
"DPL-?'{- REQUEST FOR ELECTRICAL INSPECTION ee-ooooi:oa
???Sea instructions for comolatin9 this torm on back of yellow copy. u f?a?61 ?7 n
p nq97 TA '"R'" Below Work Covered by This Request /? ti' ?? C ?
qdd Rep. Type ol BuilCine APPlianCBB Wired Equipment Wir¢d
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Api. Buildinq Dryer Hectric HeBhn
Commerclal Bldg. Fumace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tdnlc
Farm otner peci v other ISper,ltvl
tMr Suecify t er O
p Fea ServiceEntranceSize K Fea feeders?SUbfeeders il Fea Circuits
0 to 200 Am 5 0 to 30 Am s 0 to 30 Am s
A6ove 200U mps. 31 to 100 Amps 31 to 700 qm
Swimminy Poo AboVe 100-Amps Above 100_Amps
Transiormers Irrigation Booms _io BartiaL'Other Fee
Signs SUecial Inspection
?
$
1
?
- ?
TOTA E
HernTrks ni 7
-
CV r'
w 1"gJI r .
C? 40826,?i/
ReQUast Dare
?/tl (/
?
0 No.
tttM RougRi spection
Require ? ,
? Raatly Now CI Will NoNy InsOeotor
?
?
/ ? Ves No When Featly
I?(licensed contractor ? owner hereby request inspection of above electrical work at
Job Atltlress (SFreet Box ar Roule No.) ? -0 City
?
.2vo TFAf' ?e0, E??'"
SecOOn No. Townsnip Name or No. Range No. County
04il
O[CUpant(PRINTj
(dn/?5Y G°o?P Phone N0.
Powar Suppiier Address
ElecvicalCONracmr ?COmpany Neme)
ivT ?-2ICC1X?? ??2p Gonlractrns License No.
o 3? s zz -a
Mailing Adtlress IConttatlor or Owner Makinq Installation)
2 W ???/? ? ?• 1 4W?/?! ///? ???T
Awffionz iynawra rattodOwn ?g Ins:allation) Phone Number
loSYo - ?9?/
MINNESOTA STATE B 0 OF ECTRICITY TMS INSPECTION REQUEST WILL NOT
Gtlggo-Mitlway Bltlg. oom 1]3 BE ACCEPTEO 9V TNE STATE BOARD '
1821 Unlverslty pve., SL Paul. MN 55106 UNLESS PROPEF INSPECTION FEE IS
Phone(61])662-08p0 ENCLOSED.
?/?a /S0 REQUEST FOR ELECTRICAL INSPECTION j?f'?'
( ? Sea insvuctn, ns (or completing Ihis form on back oi yellow copy ,,? ?"'
C?js ?. "X" Below Work Covered by 7his Request ??rro??
e Add Rep. TypeolBUilding AppliancesWired Equipment
Home Range Temporary Service
Duplex Water Heater Electric Healing
Apt. Building Dryer Other (Specity)
Comm.Andusirial Furnace
Farm Air Condilioner
Omar (specifyi Camrador5 Remarks'
(
Campute Inspection Fee Below: 26 70l X?Z =300 ^ 'V7f
# Other Fee # ServiceEntranceSize Fee # CirCUits/Feedsrs Fee
Swimminq Pool 0 to 200 Amps O to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
S'gns InspecrorsUSeOnry: TOTAL SU
Irrigation Booms C!?? 3(? .?
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE OR6ERED DISCONNECTED IF NOT
Other Fee yp COMPLETED WITHIN 18 MO. 5.
I, ihq Electrical Inspector, hereby
certi
ih
t th
b
i
i RovBh-in oate
ty
a
e a
ove
nspect
on has
been made. Date - TJ6
OPFICE USE ONLV
inis reauest voie 18 months trom
?
?
m
64970
RepuasY?ale
? Fire N0. Rough?iiflnspeclion
RequirAC?
? Reatly NOw ? Will Natify Inspedw
Wh
R
tl
?
?2 ?Yes
No an
ea
y
I li
d
cense
contractor ? owner hereby request inspection of above electrical work at:
Job ?? (Sireet. Ba?; ? te No 4l Ciry
Section No. Township e or No. Range No. Cou
4
Occupanl?(PflI Phone No.
PowerSUpplier AGtlress
Elaclrical onlractor (Compeny Na ) Contractw5 License No.
-?-
Maling Atltlress (COntrocbr or Owmr Making Installation)
?
/
J?
7
/
/
?
J
J
J
/?`C?? . T^ Y'?'[.G7. USI/
QLL
Auth rize SignaNre (C., actor w ctileking Installatb Phone Number
O
MINNESOTA STATE ARD OF ELECTRICITY THIS INSPECTION REQIIEST WILL NOT
dtlgga-Mitlway Bld Haam S1]3 BE ACCEP7ED BYTHE STATE BOARD -
1831 WiversHy Ave., SI. Vaul, MN 55104 `9 UNLESS PFOPER INSPECTION FEE IS
PhOne(6/2)602-0800 ? ENCLOSED.
/riICAL INSPECTION esooom.m ?
KCUUEST FOP ????9 this form on back of yellow copp
? saa,,elow Work Covered by This Request
? -
:U 4 .7 ( AppliancesWired EquipmaniWired
ew AtlU qep. :F Range Temporary Service
Duplex Water Hea[er Electric Heating
Apt.6uilding Dryer O[her Specity)
CommJlndusirial Fumace
Farm Air Conditioner
Dther(specify) Conhaclor5 Femarks:
Compute Inspection Fee Below:
V
# Other Fee # ServiceEniranceSize Fee # Circuits/F de ee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transfortners Above 2W _ Amps 100 _ Amps
Signs Inspeqor5 Use Only: TOTAL
Irrigation Booms ??. ? ]
Special Inspection d
Alarm/Communication
Other Fee ??'p
I, ihe Electrical Inspector, hereby
certify that the above inspedion has
been made. Rough-in
Final
a1,/p
oa?a o
oe?e ?
JU •
jOFFlCE USE ONW '
This request witl 18 monros hom
6,?
.
?5b
?
M6467 / /
ReQuesi D
?`
?
9 Fire Roughln Inpsenion Require0
(YOU musl cell inspetl r en reatly) Mspection Other Tha ougn-In
? qegeY Now 'ill NatiN Inspeciar
( ? Ves No DateAeaay
I 71 licensed contractor D owner hereby request inspectioaof above electrical work ak
Jao Atlaress tslreet. eox or Rome No.?
?JoOO CiH
Section No. TownsM1ip Name o. Range No. Goonry
Occ
upa
11 nt(PRINT) Phona No.
H rr,
PowerSUpplier Atltlrese
Eiecvicai Gomra or IGomoany N a?i ?
?
? Convacbr5 LicenSe No.
06043aln
?r•
? cr?
Mailing AOtlness IComracbk or Ow `r M.kng Installalion
.5uth. i,p gnalure ICOnrtaclcr er +¢n. g InstallaLOn,
n a.r, f I'-c-1l ey'( A J Phone Numbeqr
L 6- 1
-?
MINNESOTA STiTE BOARD OF ELECTRICITV TMIS INSPEGTION REOUEST WILL NOT
Griggs-MiUway BIEg. - Raom 5-193 BE AGCEPTED BY THE STATE BO/+RD
1821 UnlversHy Ave.. SI. Peul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Vhone (612) 642A800 ENClOSEO.
? ee-ooooi-oe
(1+?? REQUEST FOR ELECTRICAL INSPECTION
See instmotions lar completing this lorm on beck oi yellow copy
?9 /
I?G 6 4 3 7 "X" Be/ow Work Covered by rhis Request ?i m`•??
o?
ew .
Adtl
Rep. TypeofBuilding
AppliancesWired
EquipmeniWiretl
Home Range Temporary Service
Duplea Water Heater Electric Heating
Apt Building Dryer Load Management
Comm./Industrial Furnace Other (SpeCiiy)
Farm Air Conditioner
Olher(suecityl ConVac[or's Remarks. 1
nS
`
?
Compute Inspection Fee 8elow:
x Other Fee ,
oQe
l.?
# Service EnvanceSize Fee Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above-100-= Amps
Signs Inspector's Use Only. 00
TOT/?L.,O
m/
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 THS.
I, the Eledrical Inspector, hereby dte
Ro°9n"°
certify that the above inspection has
been made. Final //oG a+a .{
-/ ?
OFFICE USE JNLY
ThiS Rquest voi0 18 montM1S IrOm
Grigpe'MlCwey eldg. -
tBPt Univernity Ave., 51.
Pho. (612) 663-0600
H U4
Duplex
THIS INSPEGTION REOUEST WILI NOT
BE AGCEPTED BV TME STATE BOARO
UNLESS PROPER INSPECTION FEE IS
ENCLOSEO.
I
E6-0000 S.
REQUEST FOR ELECTRICAL INSPECTION
3
Is. See inslmciions lor compleling this lorm on back of yellow mq. S?qk ?
."X" 8eiow Work Covered by This Request
I I lomer csoec?rvi
Campute Inspection Fee Below.'
g Other Fee
ISwimmina PODI
eooms
I, the Electrical Inspector, hereby
certity that the above inspection has
been made.
JFFlCE USE ONLV
fhis request vaid 18 manths from
Air
Heater
Remarks'
2S?j/l?O?oZ
= ?'3G??
r
? y
, 3o
+
rvice Entrance Size Fee Circuits/Feeders Fee
200 Amps 0 to 700 Amps
re 200 _ AmPs
qy
Amps
Use onty: 7
300, AL
.$?
..i
THIS INSTALLATION MAY BE ORD?FIEB?9?NNECTE? IF NOT
r.nnnvLETED WI7HIN 18 MONTHS. _
? %?
? ?
f? 6 89
",
1 I, I c..?e, . .W
Request Date Fir o. Rough-in In ion
Fequired? NOTICE: Vou Must Call ElocVical Inspector
If A Rough-In Inspeclion
L71'es Is Re9uiretl.
icensed contractor ? owner hereby request inspection of above electrical work at:
Job AtlCress (SVeet, Bax or Routa No.)
.?) '?00 PI IJ'I-' "uIJ
RuGJ C'M ?
Y1
Section No. Township Name or No. Range No. Cou ?y
i..!`-
Occup?1yanIt (PRINfnA/
l PhoneiJo.
(IJ
lV'? ?fl
Ppwer Supplier Address
Elechical Coniracror (COmpany Name) Convactor's License No.
C`f-uo
Mailing Adtlreas (GOnha r or Owrier Making Inslallation?
//
P
& e
s+ S ---
,I
7
'.
, ?. i _
c,L,
Authorizetl Si nal (COnir cror/O er Making Inslallalion) Phone GNumber G ^?
?6 ? ?6 ? /
MINNESOTA STATE BOARD OF ELEC ICITV X(?/?/J THIS INSPECTION REpUEST WILL NOT
GdggsMitlway Bltlg. - Poom 5473 UNL SSEPROPER NSPEC ION OEE IDS
1821 Universl[y Ave.. SL Paul, MN 55104 Phone(612)602-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION .? Ee-0aool ns ?
M ?8 , See insimctians far completing ihis farm an back of yellow copy
? 1 "X" Below Work Covered by This Request q
e Adtl Flep. TypeofBUilding AppliancesWired EquipmeniWired
Home Range Temparary Service
Duplex Water Heater Electric Meating
Apt. 8uilding Dryet' Load Management
Comm./Industrial Fumace Other (Specify)
Farm Air Conditioner
Other (specify) ConVactors Pamarks'
wk +e 4"'?z?r
Compufe Mspection Fee Below:
# Other Fee ff Service Entrance Size Fee M Circui4s/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transtormers Above 200 _ Amps Above 100 - Amps
SIgf15 InspaclorsUSeOnty: -11 TOTAL ?
Irrigation Booms ?
?
Special Inspection J L
i
AlarmlCOmmunication THIS INSTALLATION MAY BE OFiDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 16 MONTHS.
I, the Electrical Inspector, hereby Aouynm /,. ( oace
certify that the above inspection has
been made.
? ace ?
,J --/
OFFlCE USE ONLY
This request void 18 months from
9//y?
'??la7s?
?
C? 64692
FeOUest te ~
?
„[; Fire No. Rougn-ln Inpsaciion Hea E
(YOU must call inspector when ready) Ins ection Other Tnan Roughin
? Reatly Now Will NOYiy InSpBC[ar
„'
? ?
l
a Yes
No Dale ReaCy
IPR licensed contractor ? owner hereby request inspeCtion of above electrical work at .
Jo0 Atltlress (Sheet Box or Roule No.l City
0
SecFOn No. Township Name or No. Fange No. Counry
OccupantlPRiNTI Phone No.
In
PowerSuppber Atltlress
Electncal Gomractor ICOmpany Name) ConVacrorS Llcense No.
DSTi¢r r??T.P/C T?fi
MaJing Atlorese Comracror or Owner Meking Installalion?
? " A'F<s2 ?G m/l/ S
Autho(n?e/tl,%gnawre COnnaycronOwner MaBmg Insiallauon) PM1One Number
N gU -3?0 _g?? .
MINNESOTp TATE `BOARD OFELEC? CTHICITY
GriggaMiEway BIEg. - Room 5-173
1821 Univenily Ave., St. Peul. MN 55100
Ghone(617) 602-0800
THIS INSPECTION REpUEST WILL NOT
BE ACCEPTED BY THE STATE BOAFD
UNLESS PROPEF INSPECTION FEE IS
ENCLOSEO.
q??g? REQUEST FOR ELECTRICAL INSPECTION °°"'?
M 6 4 6 9 2 lll? See this too back `f Yelrow:cOP.._ _ ?? O/ ?
-' .. --..... ..-, . ....-cv vy , nin ney utlJ! w+ly:sc:,`
ew Add Rep. Typ¢of8uilding AppliancesWired
Equipment Wired
Home
Range Temporary ServiCe
Duplez Water Heater Electric Heating
Apt. Building Dryer Load ManegemeM
Comm.Antlushial Fumace Other (SpeCity)
Farm Air Contlitionei
OIM1er(specity) Coni Remarks:
Compute lnspection Fee Belaw.+? Other Fee # ?C tr (?J Fee # CircuRsiFeetlars Fee
Swimming Paol
Transformers 0 to 200 Amps c? O to 100 Amps
Si ns
9 Above 200 _ Amps qpo?-
?O.s?a?Amps
i
Irrigafion Booms nspecmrs usa only: ? ?TAL
(
? ?v
Special Inspection
Alarm/C \
?
ommunication
Other Fee THIS INSTALLATIDN MAY BE ORDE EB-pISL`ONNECTED IF NOT
COMPLETED WITHIN 18 MONTHS '
I, ihe Electrical Inspector, hereby
certify that the above inspection has RO°9n"n ete
?
been made. Final
f?,,
o
oem Q?? ?
=
OFFICE USE ONLY
Tpis reduest voitl 18 months Irom
!Y
?y ?V l ?lJ?
? ao
Request ate
?
? Fire Nu. ouy11ni peclion Requin;tl
(YOU all inspector when reatly) Inspetion Other Than Rough-In
? Reatly Now ? Will Nutity Inspector
f
5
es ? N.
Date Read
I licensed contractor ? owner hereby request inspection of above elecirical work at:
Job Atltlress (Sifeel, Box or oule No.) Gily
Seclion No. Township Name or No. Fange No. G
1.4hG/ A
OccupaN (PPINT) Phone No.
/ ?? -
'
Pawer Supplier Atltlress
Elacl : Contracme (GOmpany Name) Gon[roclor's Llcense No.
t I ?? ? S 1 0 ,
ailin9 Adtlress (COntroctor or Owner Making lnslallation)
217 E. ,cc_Ato,zc_ Sr. lAac IfA,
Au orived^ iqnature (COnlradorlOwnerMaking Inylallation) Poone Number
v.. ? -2-
MINNESOTA STATE BOARO OF El HICIiY
Gtlggs-Mitlway Bldg. - Room S12 I
II
I
I
?I I
I I
I
I
I II
I
I
II THIS INSPECTION REOUEST WIIL NOT
8E ACCEPTED 8Y THE STATE BOARD
1821 Universily l ve.. SI. Paul, MN 55104
on,...e tei,h ae,.nvnn UNLESS PROPEB INSPECTION FEE IS
ENCLOSED.
6,J/ 7,y- ? 7& REQUEST FOR ELECTRICAL INSPECTION
100 See Inslmctions tor compleiiny this lorm on back oi yeilow copy.
"X" Below Wcrk. C? vPred by This Request
?EB-00001-0
?? ?
Ne Add Rep. Type of Building -Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Api. Building Dryer Load Management
Comm./Industrial Furnace Other (Specify)
Farm Air Conditioner
Oiher (speclly) Conlrecror's Remarks
S-rN`u c q sg {criz.c/ir?.? r
Compute lnspection Fee Belaw:
# Other Fee # Service Envance Size Fee # Circuits/Feeders Fee
Swimming Pool
Transformers 0 to 200 Amps
A6ove 200-Amps ? 0 to 700 Amps
bove 100 -Amps p.
Signs Inspector's Use Only: /-" TOTAL
Irrigation Booms
?'?
?? ? j /
z ? C7, sfi
Special Inspection
Alarm(Communication THIS INSTALLATION MAY BE ED DISCONNECTED IF NOT
Other Fee '?Q? ?' a COMPLETED WITHIN 18 MON
I, the Electrical Inspecbr, hereby Rouyh in
. Da[e
?.2
cedity that the above inspection has
6een made. oaie
OFFICE USE ONLY
l his myuest vnid 18 mnnlhs imm
s7
o- 7
-
J
?
Reques Osle Fve o. Rough-In pectio equiretl Inspection O.her Than Rou9h-In
(Y?J iN?SI aall InSp C?0! wM1en lea(1y) ? Reatly NOw ? WIII NO?iiy IOSpecro!
?.? ? Ves ? No Date Reztly
I licensed contractor ? owner hereby request inspection of above electrical work at
Job Atltlress (SVeel, Box or Route No) Gily
Sectlon No. Tonnship Name or Nn. R2nge No. Gou/
Occupant(PRINT) PM1One No.
Povrer Svppliei .
? ?
illill Aatlress
(COmpany Name)
Eledr , Gonhr Conlractors Li[ense No
-)/V/ z
ailing Atldrass (ConUaclor or Owner Meking InsffiIlallon)
277 6-. ST Ar1C !ll 5S/o.
Authorizatl SignaWre (ConhacrorlOwner Making Installalion) Phone NumDer
'L
21
/ 7W
-2
MINNESOTA STA E BOPRO O LEC PICITY
Griggs-Mitlway Bltlg. - Raom S- 28 II I I I ? II I I II II I I II THIS MSPECTION REOUEST WILI. NOT
BE ACCEPTED 8Y THE STATE 80ARD
1821 Univenity lve., SI. Paul, MN 55104
..1- .,. e,.. I UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
?? ? REQUEST FOR ELECTRICAL INSPECTION ??gg es-ooooi-os
7?_
? /?? See insimcliuns tor complating this lorm on back ot yellow copy
,
"X" Below Work Covered by This Request tIM
7
Ne Ad Type of Building - Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building ?ryer Load Management
Comm./Industrial Furnace Other (Specify)
Farm Air Conditioner
Olher(specity) ConVactorsRemerka: [/H j( /u
)"r -r6G. ?og?-?•
? C/ ,J
' CX)o
Compute (nspection Fee Below.
# Other Fee # Service Enhance Size Fee # CircuitslFee er . Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps I 11;,
Transformers Above 200 Amps A6ove 100 -Am s
Signs mspeaors use ooy: TOTAL
f? ? ???• ?G
Irrigation Booms (
Special Inspection
AlarmlCOmmunication
7HI5 INSTALLATION MAY
BE ORDERED DISCONNECTED IF NOT
Other F ?'/ O ,;,xii COMPLETED WITHIN 18 MONTHS.
I, ihe Eleclrical Inspector, hereby
Rou9h-in Oate
cerlity that the above inspecfion has F.,nai . oate ? - J I
been made.
OFFlCE USE ONLV
TM1is repuest voitl 18 monlhs fmm
L
0 ?07
Gtlggs?Mitlwey Bltlg. - Room 5428 1821 Universlty Ave., S1. Paul. MN 551D9
Phone(614) 602-0600
.?
THIS WSPECTION REOUEST WILL NOT
BE ACCEPTED BY THE STATE 80AR"
UNLESS PROPER INSPECTION FEE IS
ENCLOSEO.
°m ? EB-00001 -09
REQUEST FOR ELECTRICAL INSPECTION
See instmctions lor compleling inis lorm on back oi yellov: mpy?? i?•T //
O ?4iAV••i
0075 368 "X" Helow Work Covered by This Request tqu ament Wired
? I
??ILLi
Compute Inspection Fee 6elaw:
u=eoOY od, Qo se?
,. ;
/
I Other Fee I
I, the Electrical Inspector, hereby
certify that the above inspection has
been made.
OFFICE USE ONLV
This request void 16 months Vom
THIIS COMPLETED WIT'HINn18 MONTHSO
Date
IF NOT
Q
OiFlCE USE ONLY This requesl void 18 manllis from volidafion dob prinied in this 6ox.
Gssll /
??,?. 3r"
?/
?e
III IIII I II? ?I I I?I III III
I? II?II I I
?, ?i'?
,
?
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* 0 4 3 0 3 3 5 0?K pLEASE PRINT OR TYPE 77?
kei Dok RoogMm Inspmion required"= ? Yes [}No Inxpecfion Olher Than koughln: [$Ready N. 0 W II Call
02/05/97 ?Vou musi mll the Inspenor whe? ?eadyj Dam Rvadp
I, 65dicensed conlmctor ? owner hereby request inspection of ikie obove electricol work aY.
job ndd,e,. (smoor, eo., a rs4rb No I ry rP cade
1305 Cor orate Center Drive Ea an
Seciion No. Township Name or No. Range No. Fire No. Couny
Dakota
Phone No.
Blue Cross Blue Shie d
Power Supplje. nddre:.
Eletlriwl Connacbr (Compony Namel Conrcanor Licenu Na. ?sMr Lic No. I%ant Eittt. Only)
040445
Mailing Address (Contiacbr or Owner Pe ming Inslallotion)
1953 Shawnee R d
Amhori amrc ICmnxbr or Owner Pedorming Innollalion one No.
452-8886
EBOOOOIA-i l 8/96 STATE BW1HD COP;?'?E P75TNU17TIONS ON BACK OF YELLOW CAPY _
?/D/ ? REQUEST FOR ELECTRICAL INSPECTION
4 l lJ °? 3 5? 1n821eUniversary ABv?e rRm. S-?128,'St. Paul, MN 55104
" Phone (612) 642-0800
.IOS fi9701i.3 6 . New qddn
Home Duplex Apt. Bidg. Remad Re ir
x
Commercial
Indushial
Farm ;ii
Air Cond. Hlg. Equip. Water Hfr. Ofher. Sig71
Dryer Range Elec. Hea} ?6a h?rk of fhe white copy only.
„X" above me worK coverea oy nin F-y???,. ?,,.?, -. -- -,
Calculate l?spec?ion fee - ihis Inspeciion Request will not be occepfed without the mvect fee:
Other Fee # Service EnUance Size Fee # Circuits/Feeders Fce
Mo6ile Home Park Sfall 0 b 200 Amps 0 to 100^Amps Af 2?.0?
INSPECTOP'S USE ONLV/' /'05? 1 -- - 40.5
O
?
Boom
ihol I
Imesnganve ren
THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT COMPLETED WITHI 18 MONTHS.