1264 Deercliff Lane - Electrical Permits
Request Date Flre No. '
7 p RougRM Inspecllon
Fe uired?
Ready Now ? Will Notity Inspecta
When Read
?
? Ves No y
I? licensed coNractor D owner hereby request inspection of above electrical work at:
Job Address (Streel Box or Rawe No.) City
? .? bwm IIW/L .11? d
Senion No. Townsnip Name or No. Range No. Coumy
Occupant(PFWT) Pnone o.
? ? lf//C/G / I?jL
Power Suppher Atldress
Elecvicsi ConVactor (Company Neme) Gont ctois Licene -
k's z- LS^' '&?/ z7 ? /
MaJinq AtltlreConvacto, or Owner Ma+ing Ir.stauatiom
, ?? ? -rr.?.• s-s ? ?
Aul S?gnaWe IC /Owner Me
O ractorking In5lalla0ory
PM1Ona Number
?., ?
MINNESOTA STHFE BOPFD OF ELECTRICITY THIS INSPECTION REOUESTWILL NOT
Grigqs-Mitlwey BIOg. - Aoam 5-179 BE ACCEPTED BV THE STATE BOARD
1821 Universiry Ave., SI. Vaul. MN 55104 UNLESS PROPER MSPEGTION FEE IS
Phone(612)64Y-p800 ENGLOSED.
REQUEST FOR ELECTRICAL INSPECTION p'.a? ?; ee-ooom-oa
Z
7/?? ? See natmations far compl,'1q Ihis lorzn on ?ack ol yeliow copy.
If/
?e ,.$ 4 6 "X" Bdlow Work Covered by rhis Request
ew Add Rep. TypeoiBuilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater
] Electric Hea[ing
Apt Building Dryer Other (Specify)
Comm /Indusrnal Fumace
Farm Air Condi[ioner
Onerapecty) Gonvamor5 Ramarks.
Compute Inspection Fee Below:
# Other Fee # ServlceEntranceSlze Fee # Circuits/Feeders Fee
Swimminq Pool 410 200 Amps 6 f0 700 Amps
Transformers Above 200 - Amps Amps
SignS inspector8 Use Onty: ? OTAL
' Irriqation Booms (J ? S Je)
Speciallnspection
Alarm/Communication THIS INSTALLATION MAY BE ORDER ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, [he EleCtrical Inspector, hereby R0°9n-m ? DaYe
certify that the above inspection has
6een made. F,nai
OFFICE USE ONLY
TM1is ?equest void 18 monNS Irom
Lo2o,S3,UJ??1cLcr-ES{-?S? 333t?
35, o U
This request wiA
18 months l
?M 1? q ?api
Rnnue.st Date Fire No. Rauphr
i-ietl n?inspec[ion ?qaddy Nuw ? Will Noti}y hispec-
Peq u.
Ycs ?No [or 4:'hen ReadY
d! JaC
11. Licensea ElacVical Contrflctm I herehv reouest inspaction ol above
r'I ..... _ _
elactricel work installed at:
Sveut Address, Box or R te No.
ra?? ' - Ci
eaion o. Township Name or No. R?nge No. Cou t
Oc n[ (PRINT) Phone No.
/
P. p lier Atldress
EIB nical Conlracfor (COmo V amel p Contracytors Licanse No.
3 /
/ ? ?
MailingAdJress lConVac r or Owner Making.lnstailationl
n
%?
ized5ienature I onvactar Owher Making Insialla oN Phone Number
s -?'Goa
,
? T ILL NOT
MINNESOTA STATE BOARD OF ELECTflICITY TNIS INSPECTION REQUES W
Grigps-Midway Bidg. - Room N•791 BE ACGEPTED BV THE STATE gOAXD
1827 UniveraitV pye., St. Peul, MN 65104 UNLESS PNOPEP INSPECTION FEE IS
v1??nw 16121 297.2111 ENCLOSEO.
REQUEST FOR ELECTRICAI INSPECTION EB-00001-03
? 39 24 6' See insLUCYions for comoleting this torm an back of Yel low capy.
"'X" F?iOW `rVork Covered by This Hequest
N Add R.P. Tvoe oi Building Applionces WIreA Equipment Wired
Home Range Temporary Service
?uplez Water Heater Lighting Fixtures
Apt. Buildinc? Dryer Electric Heatin
Commercial Bldg. Fumace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm Qt n?'I Ptc' `?' tner lsuecifvl
t er ! pecliv ther Othqr
......
k .?,...., .
Fee .... ".._.._....,., --._..
Service EnlmnceSize
d
Fee
Feeders/SUbieeders
#
Fee
Circ?its
0 to 100 qm s 0 to 30 Am>s Q 0 to 30 Ain s
701 to 200 Amps 31 to 100 Amps 31 to 100 Am s
A6ove 200 qinps Above 700-Am 5 Above 100_AmPs
Transiormers Remote Control Circ. .? Partial% Fee
Signs Special InsFiection $ TAL FEE
Pemarks .( ?? '
V
PouNh-in !/?,,.
?%L=
..:' ?. j,:,
,. . 'r'`:(:;;?? Date
c
U I, t wal
^soector, heraby
; ( certily thet the nbove
Final
La«
??-w
insVection hes baen
made
.
Thls requesl vuid
18 months from
3 3 3 \'l --
?S-pU
This request voidt Z-1 Z- L f 1? CJ /? K/ f?.G1CrQ-s?'- I S?
18 months fwrn
CM ?q 9 4a
V y-?
Rppuest Dat Fire No. RBG
?Bhf?ea7ns o Uec Nt? ion ?peatly Nnw'yWill Notity, InsOec-
p [Of Wtle:fl RPBdy
-?-Licensed Eiec[ricai ConVactor I hereby reauest insoection ot ebove
' ?
-
Sttpvo-Addiess;-AoarorROUCe'No.
?? ?
J
eCim?? o. Township Name or No. Han e Na o???
Or.. ' nt (PRINT) Phane No.
I /
olie . Addrass
C?
EI c[rical CanVactor 1m a'nyN?ame-l ,
Co}M?acmr s License ?Njo.
wl ?J?' T
ner Makino Installationl
rac?to?r w
Om
Ma,ilina Address IC {?y
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p
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/? G ° J / Y-
Ihorized Signa[ure "nVactor Owner Making Installa i Phone Number
.l?cTw,,, Nnr
MINNESOTA STATE eOAflD OF ELECTNICITY
Grigps-Midwav Bltlg. - poom N491
1821 Univeraitv Ave., SL Peul, MN 55704
PhOnw 16121 297.2111
BE ACCEPTED BY THE STATE BOAND
UNLE55 PHOPEF.INSPECTION FEE IS
ENCLOSEO.
?,w E8-00001-03
pEQUEST FOR ELECTRICAL INSPECTION ,,,
Cn? 3? 2 4 3 ? See instroctiuns for comOlBti^9 this form on back ot Vol low coOK
""X"" Below Work Covered by 7his Request
w a ea "n a1. wioed
New Adr.? PeP. T fBid 9
?ommercial Bldg. humace
Industrid? ??dg. Air Con
rte rnspecuw, rer -c,v.. q Fae G?
F FeedersBubieaders
ServiceEntrenceSiza n Fee ? G 0 t. 30
n7f n 100 o 0 to 30 AmUs
"-T 101 < 20o n r?s I I s ? co
Final
Pection G „? TO FEF ?
r Date
Inaoector, hereby
certify xhet the ebove
D?ye/ ? inspection has been
. ?siP m¢de.
:t wld
from
? 5'?--
9 Co iSo s' S
9
r
J
ReQUest Date
_')Q ' i Fire No.
I Rough-in Inspeclion
Requiretl?
? Feetly Now?llpL Notity InspBCtor
s
? ? ??y F, ves A. When Peeoy?
1 G licensed coniractor >.owner hereby request inspection of above elecirical work at:
Job Atltlress ISt t. r Route No.? Cily
/5 6 e •
Seclion No. Township Name or No. Range No. CouMy
Occupant ?PRMT)
04
S eV2
u? t
Phone No.
PowerSupplier Aearess
Elxmcai Go ran r ?COmpdny Name) ConVactor5 License No.
rn av wr14 f'
MaAing A oress fCo I c
try or Owner Making In9allatipn,
/
Awno.?re S g awe IConttactor,Owner Mamn Ins!ailation)
in Phone Number
? 6 ?.iii 9533
,- - -
MINNESOTq STATE BORRD OF ELECTflICITY THIS INSPECTION PEOUEST WILL NOT
Griggg-Mitlway Bltlg. - Room 5193 BE ACGEPTED BV THE STATE BOARO
1021 University Ave.. SL GauL MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION es-ooom-oe
- lp See insvuctions br mmpleting this torrn on Dack ol yellow copy gQ y s
J4,279 "X" 8elow Work Covered by This Request ?
ew Atld Rep. TypeofBUilding AppliancesWireU EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apl Builtling Oryer Other (Specify)
Comm.llndusirial Fumace
Farm ir Conditioner
Other(sUecdy) Conlraclor's Remahs: /
n /if
Compute Inspection Fee Below:
Other Fee # ServiceEntranceSize Fee # Circuits/Feetlers Fee
Swimming Poal 0 to 200 Amps G to 100 Amps
Transtormers Above 200 _ Amps Above 700 - Amps
SignS InsOecmr§ Usa ONy: TOTAL
,
Irrigation Booms 75
Speciallnspection 6
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspecror, hereby aO°9n-'" oate
certity that the a6ove inspection has
been made. F;,,al oa?
l0"
OFFIGE USE ONLV i This repuest void 16 monms !mm
This request voitl Z Z p
18 months from J1 r?s?- ! S? 33.3 l?
U 39245
3S, o ?
Faquest [)ate Fire No. Rou h-
7 nsDection
u
Rey
iretl
?Y ?N E]Heatly Now laNlill Nnlify Inspeo-
[ Wh
f y CV 1n` V fl dv
? OwOOr 1 hBfeby raquest inSpBClion Of 86ova
Street !yddress, Boz or Foute No. elec[rical wark instelled eY
? Cit
? T h p N_ ? ?'s7I /? I
INT)
onvactor
No.
A
ffi
u
or ed Sipnature (ConV tor?Owner Making Installation
? Phone Number
. ???o
MINNESOTA STATE 90AND OF ELECTqICITV
Gri99s-Mitlwey Bldg• - poom N-191 THIS INSPECTION PEQUEST WILL NOT
1821 University Aye., St. Peul, MN 56104
Phone 1672) 297.2117 BE ACCEPTEO 9Y THE STATE BOAqD
UNLESS PHOPEN INSPECTION FEE IS
ENCLOSED.
Gn ? n? 4 C ? EQUES7 FOR ELECTRICAL INSPECTION ,-., EB-00001-03
? ?J Soo instroctions for completing this torm on back of yellow copy. ??'
??X2r„' 'nw Work Covered bv This Renua?t , ? ? 1"7
Ne qnd Rep. Type ol Building Appliances Wired
Equipmen[ Wiretl
Home Range Temporary Service -
Duplex
Apt. 8uilding Water Heater
D Liyhtiny Fixtuses
Commercial Bldg. ryer
Furnace Electric Heatin
Industrial 81dg.
Air Conditioner Silo Unloader
Fgrm
Other i ueafv Buik Milk Tank
Other ISUecifyl
t er Spocify ? er Othnr
Comput e lns pection Faa RAi,,.,
# Fee ServiceEntrence$ise fl Fee Faetlers/Subfeedars N Fee Circui[
jig,
? to t00 Am s
O to 30 Am 5 s
? O to 30 Am
101 to 200 qmps 31 to 100 Amps 31 to 700
Am
Above 200
Amps
Transiormers Atwve 100_qm s Above 100_Ari
RemoteControl Circ. ?y"p Partial-'Other Fee
Remarks
Rough-in JV '?
? /?
f .
/
??
'
? ty
?
ec
hil
Final ?
?
? 1 nspaetoqhreb
I y
,10
e
certit1het Ihe nbova
inspection has been
_ medo.
s ropuest vo
momhs hom