1006 Danbury Ct - Electrical Permits
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RequestDate
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?ieatly Now ? Will Notity Inspector
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I;Klicensed contractor ? owner hereby request inspection of above electrical work at:
Job Atltlress (Sheel, Boz or ^RoufAe Na )
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Sechon No Township Name orNO Rarge No- CmmDsrlbT.4
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Occupant (PRIM)
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Pnare No.
Power Supplier Atltlress -
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Elec?nwl ntractor (COmpany Neme) c
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` Contrecta5 Leense No.
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Mailing AGdress (COniractor or trxner Meking Installation) '
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Authonz $ignatu (Cantrflctorl0?p e?r + In J@sfalietion)
c.? ylt?/ ?Z Phone NumDer
,56 1- G. SiT- !2.
MINNESOTA STATE BOAHO OF ELECTflICITY THIS INSPECTION FEQUEST WILL NOT
Grigge-Mltlway 81tlg - Room S-173 BE AGCEPTED BYTHE STPTE BOARD
1821 Unhersity Ave., SC Paul, MN 55109 UNLESS PROPER INSPECTION FEE IS
pryone (612) 642-080p ENCLOSED
I REQI.IEST FOR ELECTRICAL INSPECTION ee-oooma?
w See insimcLOns ior [ompleLng Ihis form on back ot yellow capy
R 93168 J(" Below Work Covered by This Request
ew Add Rep TypeofBwlding ApphancesWiretl EquipmantWrted
Home Fiange Temporary Service
Duplez Water Heater Electric Heating
Apt Building Dryer O[her (Specify)
Comm./Industrial Furnace
Farm ' Air Conditioner
01her (specdy) Cornrador§ Remarks
7'triZv'J. 58?Rclc?('r
Compute Inspection Fee Be/ow:
# Olher Fee # ServiceEniranCeSiza Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps _!)e?
Transformers A6ove 200 _ Amps Above i00 _ Amps
SignS Inapemor5 Use Onty. TOTAL7
Irrigation 8ooms
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Special Inspection ! L ,
?• a,
Alarm/Communication J
O[her Fee - "" -`-:}'? *?•?' ? .?
I, ihe Electrical Inspector, hereby Rougn,n i- _ oate
certify that the above inspection has
been made. Fnal
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OFFlCE USE ONLY ?
This request voitl 18 moMlfe imm
P 28956
flequest Date
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equire
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I 1icensed contractor ? owner hereby request inspeclion of above eleclrical work at:
Job ress (Slreel, Box or wte No )
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Secaon No 7ownship Name a No Rarge Db Cou^N
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Occupant (PRINT)
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IflzA PMne No.
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PowerSUppler .
A'DTB? EI EC? ? C Addresa ..
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Elec[n I oiriractor (C-mpOrry Name)
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Mailing Atltlress (Conhacbr or Owner Meki slallation)
AuMerrzed Sign /r9 (Conirac[a? ner aki?g ? on) Plwne NumUer ???
MIN ESOTA STATE eOAND OF ELECTRICIN THIS INSPECTION REQUEST WILL NOT
Gflgga-Midway Bltlg. - Haom &173 BE ACCEPTED BY THE STATE BOARD
1827 Univer911y Ave., SL Peul, MN 55109 UNLESS PHOPER INSPECTION FEE IS
Plrone (612) 642-O800 ENCLOSEO
I rf?REQUEST FOR ELECTRICAL INSPECTION ?q e9e-ooom-o7
ji? See mSPjctu',`ns for complefing mis lorm an beck a( yelbw copy
L5 $ 9
e bb "X" Below Work Covered by Ihis trequ
Builtling AppliancesWi esr
EqmpmentWired
Range
Water Heater Temporary Ser vice
Electric Heating
g Dryer Other (Specify)
stnal Fumace
Air Conddioner
?
Coniractor5 Remarks
Compute Inspection Fee Be/ow:
# Othar Fee
# ServiceEntranceSize Fee # ircuitslFeeders Fee
Swimming Pool
Transiormers 0 to 200 Amps
Above 200 _ Amps o to ps
SIJf15 j?
Inspector§USeOnly 0r TO?L
V l(
Irrigation Booms /
/
Special Inspection
AlarmlGommunication ?
Other Fee
I, the Electrical Inspector, hereby Rau9Rin
certify that the above inspection has
been made. Fnal D8 .?
OFFICE USE ONLY
Thm request voi0 18 momms trom
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