1965 Jan Echo Tr - Electrical Permits?REQUEST FOR ELECTRICAL INSPECTION
0033625 10- See inshu<Gons lor completing tha (orm on Oack ol yellow copy.
"X" Below Work Covered by This Request
ff^RL?
°-
??+? ? -
Na Add Rep. Type of Building Apptt2n.es+,Lired Equipment Wired
Home Range Temporary Servwe
Duplex Water Heater Elednc Heating
Apt. Building Dryer Load Management
Comm./Industrial Fumace Other S eci )
Farm Air Conditioner
Other(specily) Contr9clar's Rem9rk . d
Cqmpute Inspectian Fee Belaw., 100
? ??? ?0????
#. Other Fee k Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps I IS-.00 f 0 to 100 Am s
. Transformers Above 200-Amps -Above 100 -Amps O
SIgfIS Inspector's Use Oniy i O TOTAL
Irrigation Booms ? ?' -1, 50
S ecial Ins ection
Alartn/Communication THIS INSTALLATION MAY B ORD DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 1 NT . ?
I, the Electncal Inspector, hereby Rough-in ? oate
certity that ihe above inspection has
baen made. Date
, E USE ONLY ? ?
requesivoid 18 monihsirom
o? Y6r5,??r??
Request Date r Fire No Rough-In on Reqmred
(YOU teil inspeCjqL? ??when ready)
Ves " No Inspection Otharthugh-In
0 qeatly Now Will Notity Inspector
Date Read
Ilicensed contractor ? owner hereby request mspection of ahove elecVical work at
Job Atltlress (Slreeq Box or Poute Na )
lqlu ? ? ? Ciry/--/;
l? (?C- GC?
Sectmn No Township Name or No Range No Counry
U
OFCUpant(PFINT)
j?
? Phon S?0
!? 0
PowerSUppller
IV` ??c??1? Atldres1s
.?.zo'V 1 Lk)ef+_
lectr t o?Uactor ICOmpany Nam
????{ ConVacloi s trtense NO
lou
M/aJiling pGtlress (COnb c?or orP1 w?ner Mab/pq I{f'?st?allalion
/?]??]
L Cg)- y`- 51 fj? . T!_.W` ?}/? ? / I w S" `-' /
V9 t 1
ANhonzeG Signalure (COMradodOwnar Mekmg Insl Ilatmn)?/?)
hOV ?vA'i `-^i? ?-?`--??/i " `- Phone Number ?y?
// -iV
MINNESOTA STATE BOARD OF ELECTflIpTY THIS INSPECTION REOUEST WIIL NOT
Griggc-Mltlway BIEg. - Poom 5426 eE ACCEPTED BY THE STATE BOARD
1821 Unlvenity Ave., SI. Paui, MN 55104 IINLE55 PflOPER INSPECTION FEE IS
Phone (612) 892-0BW "? ENCLOSED
OD y3/64
? 04 ]
REQUEST FOR ELECTRICAL INSPECTION
10- See mstructions 1or complettng thls form on beck of yellaw cop?
"X" Below Work Covered by This Request
?''9%E. Ee'0G0 9_
???.....
!
N A:i Type of Building Appua'nces Wired Equipment Wired
Home Range Temporery Servica
Du lex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./lndustrial Furnace Other S eci )
Farm Air Conditloner
- Otner(specNy) Contractors Femarke'
Compute Inspection Fee 8elow:
#- Other Fee # Service Entrance Size Fes # Circuits/Fesders Fee
Swimmin Pool 0 to 200 Amps O 1 0 ta 100 Amps ?
Transformers Above 200 Am s ( A6ove 100 -Amps ,00
51 ns Inspecior's Use Only TOTAL
Irrigation Booms JG
? `?7, 5b
S ecial Ins ection OT/
Alarm/Communication THIS INSTALLATION MAY BE OR? E DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 M0j1T (
I, the Electrical Inspector, hereby Rougn-in +
? a?e
certity that the above inspection has
been made. F?nai ?e
OfFICE USE ONLY
This requast vob 18 months irom
J0030 4 ? ???0 ?"`
?
4rp
a `,O
7,
R6quest Date
2 , I
I I
?'?` Flre No. gh-In Insp on equlretl
ou t cell inepeclor hen reaty)
? Ins ectlon Other Th?9 ougn-In
?] Featly Now IXI Will Nollty Inepedor
T
?
( Yes
No ?9Ie Fiead
Ilicensed contractor ?owner hereby request Inspection of above electrical work at:
Job Adarese (Sheet, Bax or Route No )
'
? Ciy
r
1y V Gt ?
Sectlon No. Township Name or No Range No. County
Occu nt(PRINT Pth'?onra No.
1. ' 0
Power Suppli¢r
?c?Ko+c.? Clec'4r? Addre S
?U-
?1-_
Eleclncal Contrectw (COmpeny Name)
S C?fC? ` Cont/racloJt?s Lkense No ?I
00 Vl-Q
MNAdtlress (C ntractor or Owner Making Inslel)
ANhwrzeC SlgnaWre (Com\raclorlOwner Meking nstal?(a?0on)
?VVi`-'?.r/`-ciY1? Y.NYI n Phone Num6er ('/
Z"LI-ZV3S
MINNESOTA STA7E BOAND OF ELECTRiCIT4 ? THIS INSPECTION REOUEST WILL NOT
Orlgga,Midway Bltlg. - Noom 5-128 ?, f^ /? , I^ BE ACCEPTEO BY THE STATE BDARD
1821 Univenlty Are., St. Paul, MN 55704 ,?-/, vpC'?V ? UNLESS PROPER INSPECTION FEE IS
Phane (614) 60241800 ?J" (1 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ee oooi-os
? ??k
00335P ? See insttucUOns br completing this form on back o1 yellow copy ;
1?
/p/o2 rj "X" Below Wo[(LCovered by This Request
Ne Rfid Rep: Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Eleclric Heating
Apt. Building Dryer Load Management
Comm.llndustrial Furnace Other (S eciry)
Farm Air Conditioner
Olher (speciy) Comracmrs RemerYSCampute Mspection Fee 8elow: 100 p
"'
# Other Fee N Servica Entrance Size Fee # Circuits/Feeders Fee
Swimming Paol ' 0 to 200 Amps ?,oo jl 0 to 100 Amps ,00
Transformers Above 200 Amps I Above 100 -Amps 7 oU
Si OS Inspectors Use Only. ? TOTAL
Irrigation Booms _77-?-?Q
Special Ins ection
Alarm/Communication TFIIS INSTALLATION MAV BE R D DISCONNECTED IF NOT
Other Fee COMPLETED WIT MO
1, the Electrical Inspector, hereby
di
th
h
i
b
h Rougli / T Date
ce
ty
at t
e a
ove
nspection
as
been made.
Fi"ai ? ? /
bale
OPFICE USE ONLY
Thia request voitl 10 months from
003Z2 3 4-- ? ?Sv°
/
Request Dete Fire No.
? 2
1- 9 ough-?rt Iion Reqwred
U ust ca I inspector when reatlyJ Ina eceon Other Then jiough-ln
? Reetly Now O'? yyill NoLty Inspeclor
- Vas ? No Date Ready
I[Ylicensed contractor ?owner hereby request inspection of above elec[rical work at:
Job Atltlress (SVeet, Box or Roula No )
1°I72- DVetlanq' Gbrd2 Ciry
Sectron No. Townshtp Nama or No. Range No County I ?
0 1 ?
Oc pant P?n
1CJ pIM) / S.
Phone
Power$uppher
c?? - eC
+?'i • Atltlres
?
?-
,
. ?
Elec[ncal Conlrador (COmpeny Name) Contractor's Llwnse N.
c Oo'
0
.
\, lJA
D•
l.
\
`-C
MaAmg Atltlress (Contrad r or Owner MaWng Installation)
551 M
Authwized SignaWre (CONracbr/Owner Making Installalion) Phone NumOar
-Z
MINNESOTA STATE
eag. e Raam SF 'ZBECTIIICITYn, /-? L THIS INSPECTION REQUEST WILL NOT
Ggga V?' ?J ?/?/? BE ACCEPTED BY THE STATE BOARO
1827 Unlwrslty Ave., $6 Paul, MN 55100 J/ //?jy?(? UNLESS PROPER INSPECTION FEE IS
Pho. (612) BC2A800 ?/ ?'?'"q ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ee ooooi-o
Ill Sea instructlans tor campleting this farm on back ol yellow copy.
00,33622
X" Below Work Qovered by This Request ???ti•
e Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heatin
Apt. Building Dryer Load Management
Comm./Industrial Fumace Other S ecif
Fartn Air Condftioner
Olhet (sl Conlracto(a RemaMS',
Compute Inspection Fee Be/ow: I?D(?
# Other Fee # Service Entrance Siza Fee # Cvcults/Feeders Fee
Swimmin Pool 0 to 200 Am s ,00 1 0 to 100 Am s , W
Transfarmers Above 200-Amps Above 100 _Am s 7,oD
SI OS lnepeaors Use Only: _ TOTAL
Irrigation Booms ) 1 ' '? 0
S ecial Ins ection
Alartn/COmmunication DISCONNECTED
7HIS INSTALLATION MAV BE RDE IF NOT
Other Fee COMPLETED WITHIN ONT f
I, the Electrical Inspector, hereby
cetlity that the above inspection has
been made. Rough-in ?
?
8 oata
oeie
OFFICE USE ONLV
lI
Tliis reQUesl voltl 18 monMS tro.
0 ? 2 ? • .?` ,?P°
Fequ Det
-
r
`
' Flre No
(VO ug?In Ic Nion Repwretl
U all Inepector when reedy) Ins ction Othet Th?ough-In
?Reatl
Now Will Notlt
Ina
edor
I y
?
_ 1
,L..I `? Vee ? No p
y
y
?e[B Read
I licensed contractor ?owner hereby request inspection of ebove electrical work at:
Job Atltlress (Sireet, Box or Route No ) City
I W ' i 1 ? e a.
Secbon No. Townsnip Name or No. RanBe No CQ1Unty
?
Oc n1(P I 1 ??? Phone No, ? 0 O
5
PowerSupplier
L AEdrass
?
l
t. ?
, .
EI cttlcal Contraqor (COmpany Name)
ol ?h. I-e-&-hriCO..I ,
?ruc-kon Contracto s l'¢ense No.
LfOCo
Mailing Atldress (` COntrector r Owner Ma I?natallatwnl
AuthotlzeE SignaNre (ConlracroNOwner Makln Insl Ilation)
l
? Phone Number
-? 3s
i
?
MINNESOTA STATE 80ARU OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Gdgga-MlEwey Bltlg. - poom 3-148 G BE ACCEPTED BY THE STATE BOARD
1821 UnWarcity Ave., St. Gaul, MN 55104 UNLE55 PROPER INSPECTION FEE IS
Phane(61R)64E•OB00 Il ENCLOSED.
0-/i
515?? 7 REQUEST FOR ELECTRICAL INSPECTION 90
11- See msimctions lor cromplelmg this form on back ot yellow copy ,
"X" Below Work£overeci by This Request
N Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
uplex Water Heater Electric Heating
pt. Building Dryer Loatl Management
I omm./Industrial Furnace Other S eaty)
Fa" Air Conditioner
her (speally) CoNractor's R/?smarks,
Compute Inspection Fee Below: ? ? ?I ? ? L"" ?? " " ?' ? ? I v ~
# Other Fee # Service Entrance Siza Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Am s pf) ! 11 0 to 100 Amps
Transformers Above 200_Am s Above 100 -Amps -7A0
SI ns Inspectoi s Use Only. TOTAL
Irrigation 8ooms
Special Inspection
Alarm/Communication THIS INS7ALLATION MAY ORD ?DI$CONN EC7ED IF NOT
Other Fee COMPLETED WI7HIN 78 Q THS/
I, the Electrical Inspector, hereby Rougn-,n v ,
? 1ne
certity that the above inspechon has
been made.
Final
? ale
OFFICE USE ONLY
This request voitl 18 monlhs hom
?927 g
Requ sl Oale
I `? I_n ?(
?-
? Fire No oughl ecLOn R d Ins echon Other Than ough-In
fYw t call mspedorwhen ready) ? Ready Now ?Wtll NotOy Inspecror
J
? Ves No Date Reatl
I licensed contractor ? owner hereby request inspection of above electrical work aT
Joq Adtlress (Street Box or Rou[e No )
?ver av?d ? ,Le, Qty
?r c??r
Sectwn No TownsNp Name or No Range No Counry
Occupa9((PRINl7?
r) Ph???-
P?ower Supplier qtltlress (? p
?Nll`?o+ir) 6?' ?-C
E cmcal ontractor (Com any Neme] ' Contrac[or's Lmense No
GA ocLlo?
l?
? -Fn
"
o
,
?
o .
Madmg Adtlress (COnlrac ot or Owner Makinq InsffiIlabon) ?? j 4jAJ 5/ j67
JI
le I
ANhonzea iqnaNre (CONraclodOwnar Makmg nstallati )
0 l,v?(?-novcrnz Phone Number
224-7?33
MINNESOTA STATE BOPRO OF ELECTqIR1111 THIS MSPECTION REQUESt WILL NOT
Griggs-MiEway Bldg. - poom 5-128 BE ACCEPTEO BY THE STATE BOAqO
1821 University Ave, St. Paul, MN 55104 11111111111111111 I 1111111111111111111111 UNLESS PHOPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR FLECTRICAL IN5PECTION ea-ooooi-o
00- See mslructions for compleiing ihis torm on back of ysllow copY S?
'X" Selow Work ?,?••ered•by This Request < •+, ?
Ne Add Rep. Type of Building Appliances Wired Eqwpment Wired
Home Range Temporary Service
Duplex Water Heater Electnc Heahng
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (5peci )
Farm Air Conditioner '
Other (spemfy) GbnVaetor's RemarNs
Compute lnspechon Fee Below: ' 00 N 1 _D
tE Other Fee # Service Entrance Size Fee # Circuits/Feeder5 Fee
Swimmin Pool 0 ro 200 Amps A? l 1 0 to 100 Amps E6. 0%
Transfarmers Above 200_Amps I Above 100 _Amps , op
Si ns irspectors Use Onry TOTAL
Irrigation Booms
Special Inspection
Alarm/Communication 7HI5 INSTALLATION MAV BE OR ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 78 MONl ?
1, ihe Electrical Inspeclor, hereby Ao»qn-lo ?e i1(f uace
cedify that the above inspection has
been made. Final o-?
?. ?./,j,j?,ii°,y?•; ??' Da[e
OFFICE USE ONLY
This requeat voitl 18 monihs tram
S?SO?
--?
0° 0
26
I
s
77Ir°
/9/ 1
Requ st Date
1 I_?' ,?`1 Fire No Roug -In i, a RaQwr Inspection Olher ThT,?n {5ough-In
(VOU t call Inspedor?hen reedy) ? qea0y Now ',?1 Will Noldy Inspec?or
?
? Yes U No Data Reatl '
I ?(licensed contractor ? own r hereby request inspection of above electncal work at
Jo0 AtlGress (Slreet, 9ox or Route No )
, City
r ?
O V r G? t c av,
Settion No Township Name or No Renge No Counry }
L,?`-C)
0 cupant(PRINT) Phone No
L -I?Z c- ?LO
PowerSupplrer Atltlress
0 - Z2 ??'h S , ? -?--
Elecincal Convacror ompeny Neme7
l
) ?
C
(? CoNractoYS License No
4oc?
4
.
a
t cOn
L,
t Oo
Mailing Atltlr w(Contrac?or or Owner Making Inslallalmn)
c?? ?+ ?I-, ??cc,?,?? rv?r? 55 ?07
ANhonzed Sgna re (ConVacror/Owner Maki g Instellation)
?
? Phone Nump?r
C
7
,?`L l ,Z?l
MINNESOTA STATE BOARD OF ELECTHICITV-I
Orlggs-Mitlway BICg. • Room 5-128 / Iµ THIS INSPECTION FEQUEST WILI NOT
BE ACCEPTED BY THE STATE BOARD
1821 Ilniverelty Ave., St Peul, MN 55704? C?° \
Phone (612) 601 0 L ? UNLESS PROPER INSPECTION FEE IS
ENCLOSED
3? 6
100?..r6
9?-
REOUEST FOR ELECTRICAL INSPECTION
10- Sea insiructions tor complaling tMS torm on back of yellow copy.
"X" Below lMm+, Covered by This Request
E°0 01-0
°?i.lftl.d
e Add Rep. Type of Building Appliances Wired Equipment Wired
Home Ranga Temporary Service
Du lex Water Heater Electric Heatin
Apt. Building Dryer Load Managemeni
Comm./Industrial Furnace Other Speciry
Farm Air Conditioner
Otharispecdy) Coniracbr's Remarks:
Compute Inspechon Fee Below:
# Othei Fee # Service Entrence Size Fee # Circuits/Feeders Fee
Swimmin Pool 0 to 200 Am s l?j,oo 1 0 to 100 Amps ?
Transtormers Above 200-Am s I A6ove 100-Amps '7,no
Si ns insPecmr•s use omy '
qqq TOTAL
Irrigation Booms ??/
S ecial Ins ection /
Alarm/Communication THIS INSTALLATION MAY 8E ORD D DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 1 MON !
I, the Eledrical Inspector, hereby Roug"in oate
certify that the above inspection has
been made. Finai oate
OFFICE USE ONLY
Thrs request voitl 18 monihs Irom V
'?0
?°
Raquesl Data ire No -u Ins i Peqmretl
(You au mu wll inspeaor
when ready)
` Ins ection O1her Than gough-ln
Reatly Now ±aWill No1Hy Inspector
I Yes
b ?
No Date Reatl
I? licensed contractor ? ownar hereby request inspection of above electrical work at:
Job Address (Straet, Box or Route No )_
\ctin bcho TY?tii
I Clty
Ec? ot-
Section No Township Neme ar No. Range No. Co nry ? ?
Il? o 1-\
Occu ant(PRl T) Pho'ne ]No -7
-1 - l.. O C
Power Supplier Aatlress
a--
W?, ?-
,
.
Elecmcal Contracror (COmpeny Name)
ll n
El
l (
+ .
h
( Contraclots 4censa No
yDI
/k
a
s
fcmira
onc,
rw .0.
or) P
OU
Malling Address (COnvacior or Owner Making Instaliabon)
Z s
fil
P
M
N? I o7
.
e q,ck
Authorrzatl SignaNre (COnVactorlOwner Mabng InstallaLOn) Phone Number
b r
MINNESOTA $TATE BOARD OF EIECTRI ITY THIS INSPECTION REOUEST WIIL NOT
Grlgge-Mltlway Bitlg. - Room 5-128 G v BE ACCEPTED BY TNE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
1827 Unlversity Aw., St. Peul, MN 551 ?
V?oire (812) 602-OB00 ENCLOSED
` J
V3 j?62 0
REOUEST FOR ELECTRICAL INSPECTION
P Sae InslrucLOns far complating fiis tortn on beck of yellow copy.
"X" Below Work Covered by This Request
%,E s?Y'-°
Ne Add Rep. Type of 8uilding Appliances Wired Equipment Wired
Home Range Temporary Service
Du lex Water Heater Electric Heatin
Apt. Building Dryer Load Management
Comm./Indusirial Fumace Other S eci )
Farm Air Conditioner
Other (speafy) Coniractor's Remarks ?,
Compufe lnspection Fee Below: 10 ? k --t- 1 V?-6A
# Other Fee # Service Entrance Size Fee tt
I CircuitJEeeders Fee
Swimmin Pool 0 to 200 Amps J??Dn 1 0 to 100 Amps , pa
Transformers Above 200-Am s I Above 700-Amps Z.D
$I f1S InsDector's Usa Only, TOTAL
IrrigaqonBooms ?,?
S ecial Ins ection 4
Alarm/Communication ER
THIS INSTALLATION MAY BE 0 SCONNECTED IF NOT
Other Fee COMPLETED WITHIN 78 NTH r
I, the Electrical Inspector, hereby ROUgi oate
cenlty that the ebove inspection has
been made. F?nai ?; ?e
OFFICE OSE ONLY
This (eduest voi0 18 monthe Irom
I M 3 r20 ?
1
?. 9
77
Reqvest Date
?
q ire No. Roughl? I lon Pequirad
(YOU S? wll Ipe{SdElot when ?eeRy) Inspectron Othar Th n oughln
? ReaOy Now WIII Nolily Inspector
-
- - Vas ? No Date Raed
I?licensed contractor ?owner hereby request inspection of above electrical work at:
JoU Address (Street, BoK ar Roule No I
J??ckD i I Cit
?r? a,n
Secllon No. Township Name or No Fange No Cp\unry ? I
Occ anl(PFINT) Phone o.
Powgr Suppller r?
U (: I-cG+l'l C' Atltlress
'43W- Z(}W l ?. WeS+-
Electdcel Convactor (Company Neme)
i
n E
+
d Convactor's Ucen No.
(A saa(
v
CG
i
L n D
Maibng Atlaress (Conirector or Owner Mekln nstallabon)
? S-?
I ??
66)
z g ? e .
Authorizetl $IgnHlure (COntracbr/Owner Making In Ilatlon)
? Phone Numper
2 -Zff33
MINNESOTA $TpTE BOARD OF ELECTR- IERY -?-? (/? ? THIS INSPECTION REQUEST WILL NOT
Grigpa.Mltlway Bitlg. - Raom 8•128 C I ??f I BE ACCEPTED BV THE STATE BOARO
1821 Unlvaralty Ave., 91. Paul, MN 55100 j/?? ??l ??? UNLESS PROPER INSPECTION FEE IS
Phorro (812)602-0800 L. ' ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION ''"•`-?? ee ooooi-os
O ? 6 21? See instmctions lor complaflng Ws form on back of yellow capy ?
?? .?
/. "X" Below Work GFUerBd,py This Request ?:?r•?
?? ?
6% Add Rep. Type of Building Appliances Wired Equipment Wire
Home Range Temporary Service
Duplex Water Heater Electric Heatin
Apt. Building Dryer Load Management
Comm.llndustrial Furnace Other (Specify)
- Farm Air Conditioner
Olher(spemiy) ConVactor's Remarks
6ompufe Inspection Fee Below:
#- Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps I, 00 1 111 0 to 100 Am s .&)
Transformers Above 200_Amps Above-400-Am s
SignS inspecmfs Use Oniy?) TOTAL
Ivigation eooms ? ?`
Special Ins ection
AIartNCommunication THIS INSTALLATION MAY BE 0 DERE ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 THS. ?
I, the ElecMcal Inspector, hereby
tit
th
t th
b
i
t Roughm
? ata
cer
y
a
e a
ove
nspec
ion has
been made.
Fnai ?
ate
OFFICEUSEONLV
Thls request voitl 18 monlhs Irom
? 21
. ? • ? ? ?77?
?
K t Da e
`
l I- 2 I- q f Frt Na, ugh-In In eqmretl
(YOU u t call inspector hen reatly)
? In ecLOn Other Than Rough-ln
a Ready Now `? Will Notity Inspector
Ves
No ?ale Rea
I? licensed contractor ? owner hereby request inspection of a6ove electrical work at
Jab
Atltl
(S,reet, Box ar Roule NO CM
?
?
../
Secnon No Township Name or No Range No. County
U
Oc nt (PPINT)
I Phone No
yc z -57LO
SuppLer Adtlress
o
Electncal Conirador (COmpany Name)
I
c
t . ConVactofs License No.
C
, n- CL-f'rtLCk
t? V?.
oiiin L v. O
O
Mailing Atltlress (C nZr Owner Making nslallalion)
+? 1
Mht 510?
e
Avlhonzetl SignaWre (COntractor/?vnar Mak
-bob ing Insiallavon)
?n. Phone Number
ZZ?I -2833
MINNESOTA STATE BOAflU OF ELECTRI fTY THIS INSPECTION REQl1EST WILL NOT
Grtggs-Mitlway BIOg. - floom 5428 a-h' BE ACCEPTED BV TME STATE BOARO
7821 Unlveralry Ave., St. Paul, MN 55104 Al /: J?-. UNLESS PFOPER INSPECTION FEE IS
Phow (6121831-0800 ?/?? W? ? ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION
, ,PV?°? ' Fa-oo w-'
v? Ses inslmcLOns tor completmq this lorm on baCk ot y911ow copy ?.. s? ?
'? _ -
???j-?/???j' . "X" Below Work Govered by This Request "?a?;.p,:„.
Ne Rdd Rep Type of Bwldfng ""'Tppliances Wired Equipment Wired
Home Range Temporary Service
# Duplex Water Heater Electric Heatin
Apt Butlding Dryer Load Management
Comm /Industnai Furnace Other S ecify)
Farm Air Conditioner
Other (apecrfy) Contracror's Remarks ICottipute Mspechon Fee BelowI vO ? ? V V n Y1 p?-
# Other Fee N Service Entrance Size Fee # Circuds/Feeders Fee
Swimming Pool 0 to 200 Amps . ?rj,oo I 0 to 100 Amps 5..?
Transformers Above 200 Amps I Above 100 _Amps 7.00
SignS inspecror's use oniy: TOTAL
IrrigationBooms ??DV ??.15 C)
Spaclal Vnspection
Alarm/Communication THIS INSTALLATION MAY ED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MON
I, the Electrical Inspector, here6y Rouqn-in oa?e? /1 ?
cartity that ihe above inspection has
been made
FFai
osteZ
,
OFFICE USE ONLY
This reQUesl witl 18 mon[hs fmm
5 3 9
P
-
3 0 t?
,
-
?
?'s °
? / -;? ?
Reques Dare Flre No Rough-I
(Ywi ?ni pection Reqvire' Inspectwn OtherThan ugh-In
{ call inspeclor when ready) ? Reatl
WAI Notdy Inspecror
N.
? ? - ? y
Ves , ? No Date Read
Ix licensed contractor ? ownar hereby request inspection ot above electrical work aP
JoG Atltlress (Slreal Box or Route No ) Gry
197Lv EUh o rai I -Eco ctiv)
Seclion No Township Name or No Fange No nunly
a.Ko i-G
Occup3n[ (PRMT)
I- M.15 0? Mt4 Cor . Phon No
'-? 52- S 2.o O
Powec Suppllar
o AtlCress
vNtS
Electncal ConVacror (Company Name)
?.b1\l e \2CA-t1 G,` ?A1"1S?1nC (,? Conlredo(s Lcense N.
CI?OO t??D
Maibng AaCress (GOntraROr or Owner Makinq Installation)
2-l ??c,,? 5 il 5? P U fJ 55107
Authorrzed SignaNre (ConVaclor/Owner Makin InslallaM1On)
b Wt, ott? Phone Number
ZzN -?1S?:;:3
MINNESOTA STATE BOAHD OF ELECTRI TY, THIS INSPECTIONIREQUEST WILL NOT
Griggs-Mltlwey Bldg. - Room S-t1B ! , U
SL Peul, MN SSID} ?
II
II I
I I
I I
? I
I 9E ACCEPTED BV THE STATE BOARD
IINLESS PROPER INSPECTION FEE IS
Phona (612) 602-0BOO r . ENCLOSED
lto'?lf?1 n REQUEST FOR ELECTRICAL INSPECTION
3/ lo, See msvudions for completing Ihis fwm on back ol yelbw copy.
1,, _ "X" 8elow Work Covered by This Request
?E°?'
Neiii Add Rep. Type of 8uilding Appliances`Wired Equipmant Wired
Home Range Temporary Service
Duplex Water Heater Electric Heatin
Apt Building Dryer Load Mana emant
Comm./Industnal Furnace Other (Specify)
Farm Air Condrtioner
Olher (spemtyi CoNractor's Remarks
IOG? Tov?n?-,Gr?
Compute Inspection Fee Below:
# Other Fee N Service Entrance Size Fee # Circuits/Feeders Fee
Swimmin Poal 0 to 200 Amps 1 115,oDi ll 0 to 100 Am s ?.?
Transformers Above 200 Amps ( Above.100 -Am s 1 -7,
Signs inspecmrs Use Oniy " TOTAL
Irrigation Booms
Special Ins ection 7 ( ?
Alarm/Communication THIS INSTALLATION MAY BE ORD
ER qfSCONN ECTED IF NOT
Other Fee ,
COMPLETED WITNIN 181dO?JTFl9:?
I, the Electrical Inspecror, hereby
if
h
h Rough-m CRlO oate
? -
cen
y t
at t
e above inspection has
been made. F'"ai oate
OFFICE USE ONLY
This request vob 18 months Irom
"
"
'4
UU 3 3
1 9
b)
ReWest Date
n Fir N. g-1rcin aRepuiretl
Vou 1 call inspector when reatly) Inspeaion Other Tnen Rough-In
? Reatly Now KWIII Notlty Inapaclor
Ves ? No Dete Read
I' licensed contractor ?owner hereby request inspection of above eledrical work at:
dab AWress ?Street. Box or Route No.
? q`I h o
TYG? ? I Qry
?G? CA-
Seclion N. Township Name or No Renge No Counly
6 c-l;o
Occupant(PFINT) Phone No.
Power Supplier ?
L c4,- c)?- Atltlress
ZZD
S?. 1NeS4-
Eleclrical Contracror (COmpany Name) ctor's Ucense No
Contra
4rild Ca
Flec
?'r L. oh
U4 b(n
Mading AdOress (Cont?ado? or Owne? Meking Ins?ellabon)
z?8 ? ?-vec ? !?
MN 5?10`l
Authonzetl Siqnature (ConUactor/Owner Makmg Installation) Phone Numbar
? Zg
MINNESOTA STATE BOAFO OF ELECTRICIN (^? G THI$ INSPECTION REOUEST WILL NOT
Gtlggs-Mitlway Bltlg. - Raom SnPe BE ACCEPTEO BY THE STATE BOARD
1821 Unrv¢miry Ave., 51. Paul, MN 55100 UNLESS PROPER INSPECTION FEE IS
Phone (612) B4P-0800 ??'?? ENCLOSED.
n/
REOUEST FOR ELECTRICAL INSPECTION EB-0?0'0^01I-0
???1 8? See instruchons lor compleling ihle form on hack of yellow copy
/ r1 "X" Below Work Covered by This Request
IfitaN P,dd Rep. Type of Building Appliaices Wired Equipment Wired
Home Range Temporary Service
Du lex Water Heater Electric Heating
A t. Building Dryer Load Management
Comm./Industrial Furnace Other Spea )
Farm Air Conditioner
Other (spectly) Coniractor's Remarks 1-
Compute lnspaction Fee Below: IOC
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimmin Pool 0 to 200 Am s $,00 1 I 0 to 100 Amps W
Transfortners Above 200-Am s Above 100 -Amps -7 .oD
51 n5 Inspecmr's Use Onry J TOTAL
Irrigation Booms
S ecial Ins ection
AIarMCommunication THIS INSTALLATION E bISC ECTED IF NOT
Other Fee COMPLETED WITHIWI, NT .
I, the Elactrical Inspector, hereby Rough-in r Date
certify that the above inspection has
been mada. Final
o ?e
OfFICE USE ONLY
This request vmtl 18 months trom
0 3 y6 8 • ? ?7
Requ 1 Da[e ire No
I 1-19?_ Rough-In on y¢qWretl Ins ecIion Ofier Than Roughln
(VOU u call inspector hen reatly) ? Reatly Now . Will NotNy Inspector
?
f Ves
No oate Featl
I:1K licansed contractor ? owner hereby request inspection of above electrical work at:
Job Adtlrass (Streat, 80x ar qoute No.)
?qLugq J CKY) Ec,h
C) la(& I l Pty
Ea ci? a
Sedion No. Town9hip Nama or No Renge No County
cA-Kchi
Occ ent l PR NT)
?? i?-e, Na ?e Phone No
5 z- 5 Zoo
Powar Supplier
K k i Atldress
ZZDt ?5-?-
Electtlcel Contracmr (Company Name)
Ef -ilr'ca1
? s,Ir?? ConlracmYS L¢ens'e INo
Malling AEtlreea (COntractor or Owner Making Instelletlon)
ANhorizetl Signeture (COMracmdOwner Making Instalialron)
ob WtA&LVL/ M Phone Number
MINNESOTA STATE BOARO OF ELECTPICITY r'? THIS INSPECTION REQUEST WILL NOT
Gdgge-Mitlway Bltlg. - Room &128 C? ?/ BE ACCEPTED 8Y THE STATE BOARD
1821 UnivmlTy Aw., St. Paul, MN 55101 E /. ??.? I^ UNLESS PROPER INSPECTION FEE IS
Phone (812) 692-0800 ??? ?????? ? ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
OW 6 7lo, See insiructlons for completing this form on back of yellow copy.
/ "X" 8elow Work Covered by This Request
E?9,5 ?1.0ew Add Rep'. Type of Building Apphmlces'Wired Equipment Wiretl
Home Range Temporery Sarvica
Du lex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm.llndustrial Furnace Other (Specity)
Farm Air Conditioner
Olher (specity) Conlraaors RemaMS.
Compufe Inspection Fee Below: ? OoPi,TO W?k
# Other Fee # Service Entrance Size Fee # Circults/Feeders Fee
Swimming Pool 1 0 to 200 Amps 1?00 1 ? 0 to 700 Amps S.co
Transformers Above 200-Amps i Above 100 -Am s 7 Do
SI nS inspecmrs Use Only: TOTAL
Irrigation Booms
Special Ins ection
Alarm/Communication TNIS INSTAlLA710N MAY BE DER ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 1 TH ?
I, the Electrical Inspecior, hereby
it
b Rough-In oate
cert
y that the a
ove inspection has
been made.
F'nai
ie
OFFICE USE ONLV
This reQUest voitl 18 monihs irom
• c?rf ?p c?"
r n
Req st Dat
? Fire No
( -In Insp n Beqwretl
u calfineFeclo'v?en reatly) Ine edwn Other Than pough-ln
?PBatly Naw ?rwni NaiN inspecror
Ves U No ?ete Raetl
I? licensed contractor ? owner hereby request inspection of above electrical work at:
Job Atltlress (Street, 6ox or Route No )
i9 Lpi JO'n 5- ch o TrCA t 1 Cily
ec av)
Seciron No Township Neme or No Range No Counly
Occupant(PRINT, Phone No
Power Supplrer
1?Ko c? E 1e Address
Elecincal CoMracror (Company Name)
E l ec {?n Ca •
rt5-hu ?h (.c . Contractor's Lmanse No
c?o ? o
Maning Address (Conhacror or Owner Making Installabon)
2. ,
?.
551DO
AuNonzetl SignaWre (COnlmctor/Ownar king InsWllation) P?one Number
T?cb MINNESOTA STATE BOApD OF ELECTIiICITV??I b? II THE SiATE BOARD
Griggs-Mitlway 81tlg - Roam 5-128 E ACEPTED BV
1821 Unlvarelty Ave, St. Paul, MN 55104 ?l+C If? UNlE35 PRDPER INSPECTION FEE IS
Phane (612) 602-0800 Ci ? ?-'? ? ENCLOSEO
5&95
REQUEST FOR ELECTRICAL INSPECTION o oi-
? See mslmdions for completmg Ihis brm on back ot yellow copy
.0 ???'
.
"X" Below Work Covered by This Requesf ??°
N Add Rep 'Yype ot Bwlding -4w.ces Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heatin
Apt Bwlding Dryer Load Management
Comm./Industrial Fumace Other (Specif )
Farm Air Conditioner
Olher (speclfy) Conlracmrs Remarks
Compute Inspection Fee Below: (oo ?1DWrv" ` bKkQ_
# Other Fee # Service Entrance Size Fee # Circuitslfeeders Fee
Swimmin Pool 0 to 200 Am s 15,00 111 0 to 100 Am S S,oo
Transformars Above 200_Amps 0_Am s 7 .°o
$I fIS Inspecmr's Use Only TOTAL
Irrigation Booms ?X O .5 0
S ecial Ins ection
AIarMCommunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electricel Inspector, hereby Rou9n-in oace,
certity that the above inspection has
bean made. oe e /
OFFlCE USE ONLY
Tha request wid 18 monihs Irom
S s `177 ?
Request ate
(y
' Fve No ouph-;l oectwn Required Inapectlon Olher Th Rough-In
( ?nspeclor when reaCy) ? Reatly Now ill Notdy Inspector
?
No Date Reetl
I'K licensed contractor ? owner hereby request inspection oi above elearical work at.
Job Atltlress (Straey Box or Roule No.)
1q18 it'n =orio "rra? I Ciry
E aj=oull
SBCtlon No Tawnship Neme ot No Renge Na County
?
0 upan[1(RINT)
4- MN
d Phone No
0
pw3
r .
Power Suppliar
b?? E(e?4-'ic Adtlress
I-A ZZo 5+r e-?-
Elecmcal Cont2cror (GOmpany Name)
C?\\?' S E?.cfinc 1 (Aos? uhoh C'a. Conlraclor's License No
CA oo-l- ?
MaNng AtlGreas (Coniractor or Owner Mekmg Instellation)
27 S?..t? S Pau 1 M N ? ID ?
Authonzetl S neWre COntraclorlOwner Makmg Installe[ion)
f o .e?c? ILvn Phone Number
ZZq -29133
MINNESOTA STATE BOAFO OF ELECTPICITV
Griggs-MlEway Bldg. - Poam 5-128
51 Peul
MN 51 d
??
11111
I
I I
III I
I ?
? I
I
1
1
1111
111
11111 THIS INSPECTION REOUEST WILL NOT
11 BE ACCEPTED BV THE STA7E BOARD
OPER INSPECTION FEE IS
UNLESS
,
L` -
??
Phane (814) 6 2 OB00 u E
NCLOSED
REQUEST FOR ELECTRICAL INSPECTION o 00 X(?qy
J ` ? See mstmctions far completmg this faRn on back of yellow copy ;, V ?
5 Q 8elow Work Covered by This Request
Ne? TAdd Rep Type of 8uilding .ances Wired . Equipment Wired
Home ange Temporary 5ervice
Duplex q Water Heater . Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (Specrfy)
Farm Air Conditioner
Othar (speairy) ContraOtar's Remer1ks' , V?v f 1 ?? ,^, In n
ll ?• Wl .v'?
Compute InspecGon Fee Below: loo
# Other Fee # 9ervice Entrance Size Fee # CircuitslFeeders Fee
Swimming Pool 0 to 200 Amps 10 0 to 100 Am s
Transformers Above 200_Amps 11 Above 100 -Am s T.o-D
SiqnS Inepecror's use onry TOTAL
trfigation Booms 7-U6
7 -7-7,50
S ecial Inspectwn /
Alarm/Communication THIS INSTALLATION MA URDE DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO S.
1, [he Elechical Inspector, hereby ?ouqn-in oa?e?
cedify that ihe above inspection has
bmad
Finai
oate ?
FICE USE ONLV
s request voitl 18 monlhs frem
0-P3-541
?
Requ st Dafe
1,? r
Q
"
'
_
-1 Fire 1 o For^ - spec1l n Reqmretl spectmn Olher Tyan 5ough?ln
(V Kfispector when ready) In? Pefltly Now
1rS?,t? ill No?Ry Inspeemr
J
?
'?
LI les ? No Date Aead
1' hcensed contractor ? owner hereby request inspection of ahove elactncal work at:
Job Atltlrass (Street, 8ox ar Poule No J
MO Jci.n EUio Tv-a,c I CAy
Section No TownsMp Name or N. qange No County
'?Lfa
Oc pant P INT)
?U,t ? k?oNq a? MN Co Phone No
y52-5200
Power Supplier Address r /
Electncal Contractor (COmpany Name) Con[racror's License No.
I(? _ le +ri al n G?w . Ck o o yolp
Mailing AGtlress (COntrac[or or Owner Making Installatwn)
5+-c,ta S?e+ v?, cu.?.l ,??•I 55?0?
ANhonzed Signalure (COnlraclovOwner k g Inslallapon)
Wearr? Q,vn Pbone Number
ZzLf-2833
MINNESOTA STATE BOARO OF ELEC V
?N
Griggs-Mitlway Bitlg - Room S1 ??. /v-
?
II
I?
I
( I
) I
I
I I
I
I(
I I
I TH
IS INSPECTION REQUEST WILL NOT
BE ACCEPTED 8V THE 5TATE BOAFD
1821 Unlverelly Ave., St. Pau 5 IIA?1??4
Phone (612) 642-0800 '?? O UNLESS PROPER INSPECTION FEE IS
ENCLOSEO
REQUEST FOR ELECTRICAL INSPECTION ? ??e-ooo i
? 11, See mslmctions for compleling ihis brm on bace of yallow oapy
C5/?'f`(,5 "X" Below Work Covered by This Request
Ne AtleRep. ' Type of Building ices Wired . Equipment Wired
Home Range • Temporary Service
Duplex Water Heater Electric Heatin
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (Specify)
- Farm Air Conditioner
Other (speafy) Conlmctor's RemaBS I? Compute Inspechon Fee Below: 100 A
•
# Other Fes # Servwe Entrance Size Pee # Circuits/Feeders Fee
Swimmin Pool 0 to 200 Amps L 0 to 100 Amps I L-Z op
Transiormers Above 200 Amps I Above 100 -Amps
SIg05 Inspector's Use Only. TOTAL
Irrigation Booms ??? a(J -7, 50
Special Ins ection
Alarm/Communication THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electncal Inspecror, hereby Rou9n-in , oeI??.
certify that the above inspection has
been made. pinai 0817
OFFiCE IISE ONLY
This reQUest voitl 18 manthsirom
0
7?
3? 5 4 2 "
6
9
,C/
Request Da[e
y? I 2 ]y? /h
" 1 `?-)
- ` Fire o Roug Inspeciwn Repmretl
(V ^ mspector when leatly) Inspechon O[?er Than Roughin
Reatly Now ?Will Nolily Inspeclor
El
I
? es ? N
o Date Reaa
I licensed contractor ?owner hereby requelst inspection of above electrical work at:
i
Jeb Atltlress (Street Box or Route No ? I
qq2 JO..n Eono Trai Cily
?Q aki
Sedion N. Township Name or N. Range No Cowry
NA.Ko-Izi
o?9a?<<PA?NT? ?ot,n.? ? M?v (`,pr . Py'e N2-?2Ao
Power Sup0lier
baKbvix ?lec?ic. AtlGress
y3bo 22o+i? S-I-rte-I- INes+-'
Electncal Contraclor (Compeny Name) .
C011I6S £l,pC{'h'CLt CAr15{1U(.h0n ?. Contracror's Lmense No.
CA-00q0(.0
Mailing AEtlress (COntrzctor or Owner Making Installahon)
27 $5?G.to 107
Nuthor¢ed SignaNre (COnimcror/Owner Makmg Instelletion)
P o b vJ exd.un. . Phone Number
2zN Zg33
OARO OF E TRP.
Grlggp?MlEwey Bldg. - Room 5428 ?-. ??
A
p
s ?I II I I I
? I ? I I I I I I I 11 11 1111 THIS INSPECTION REOUEST WILL NOT
BE ACCEPTEO BV THE STATE BOARD
1821 Unlversiry Ave., 51. Peul, M ?A??'?
Phone
61P
662
7?
BDO ?
? UNLESS PROPEfl INSPECTION FEE IS
ENCLOSEO
/fOe3'f??
s=543 0 ?'
??
5
ReQuest Oa e
?
n Fre 010 Rough nspec on Reqwred
(YO calfHiSpector .vhen reatly) Inspecimn Other Than Fjovgh-In
o Reatly Now ?i?Will Nobty Inspector
_ Yes ? No Da\e Read
1 0 licensed contractor ? owner hereby request inspection of above electrical work at:
Jab Aatlress (Streat, Boz or Raute Na ) ciry
• q8'-I EUl o Trow I
Section N. Township Name or No Range No County
I "
I Fti
Occupant?PRINn
Pid, lu.t o? M,N r. Phane No
452-52-0o
Power Suppber
b ck,y'n v a C le.c.-h-? c Ad@ess
N o?1-? 5?,- .4 s
Electncal C
ontractor (Company Name) Comracror's Lmense No
f
U"?hr) 61QC?ia1 ` .
MaAmg AtlOress ?(Con?lra"ctor or Owner Making Installalmn) ^`?l ? /? ? (
-?
I
e61
A
vl'
i?\IV
"
2 1 1 ?
Authonzetl SignaWre (COn[ractodOwner Makmg Installallon) Phone Number
i Ob W,cs,ct?.? .?.m 22y-2_933
MINNESOTA STATE BOARD OF EL CTRI ITV
Griggo-Mltlway Bltlg. - iloom 5-128, _,
?
II
II
I
I I
I I
I I
I
I THI$ INSPECTION REOUEST WILL NOT
BE ACCEPTED BV THE STATE BOARD
??
1821 Univarsity Ave., St. Paul, b?N BS?Ib I UNLESS PROPER INSPECTION FEE IS
PM1One 18121 F42AP00 ? l?? I ? FNf.I OSFO
REQUEST FOR ELECTRICAL fNSPECTION °•?9^\ 8 pRppi
? See inslmctions lor compleung this lorm on back ol yellow copy +}
/
"X" Be/ow Work Covered by This Request
Neu Add Rep. Type of Building Rppnmrces Wired Equipment Wired
Home Range Temporary Service
. Duplex Water Heater Electnc Heatin
Apt. Building Dryer Load Management
' Comm /Industnal Purnace Other (Specity)
Farm Air Conditioner
Other (spxJy) Conlractor's Remarks
' OCompufe lnspecfion Fee Below: ? ? ? ?? ? ?y
# Other Fee # Semce Entrance Size Fee # CircurtslFeeders Fee
Swimmin Pool 1 0 to 200 Amps 15 'o v ? I 0 to 100 Amps ,oa
Transformers Above 200_Amps 1 Above 1D0-Amps l.oo
Si nS Inspecmr's Use Only TOTAL
Irrigation Booms :D ?? , 'r' 0
Special Ins ection (
Alarm/Communication ??
THIS INSTALLATION MAY BE ONNECTED IF NOT
Other Fee COMPLETED WiTHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rougn,n oato
'r
certiry that the above inspection has
heen made.
F'"ai
oe?e
OFF'ICE USE ONLY
Thls request voitl 18 months (rom
-5 4 4 ??a
D
.
?' ?-7
°? ?
? -?
5
?
?
l
9.
Req est 0 te Rre No ough-In ir ' n Reqwred Ins eclmn Other Thflugh-In
when reatly) ? Reatly N. Wtll Noely Inspeclor
?l _ Zg _Q5 (VOU ector
? N
o Da[e Peatl
I? licensed contractor ? owner hereby request inspechon of above electncal work at.
Jab Address (Slreep Bax or Faute Na)
IqBCo Jck-n C(A/Yo '! CAy
E an
SecLOn No Towns hip Name or N. Range Counry
7 7 t)c'?i q
O<c ant (PRINT)
• ke, t?tl,S a? MN o+? . Phone No
L152-S2-oo
P.wer Supplier
??Kokc' Atltlress
ee?f -P -?-
4300 220+ti
Eleclncal Conhacror(Company Name)
Col I+n ele.t.A-6cr,k.l C0ns-1McAk6V-1 . Conhac[ors Lmense No
Cri yDtv
MeAing Adtlress (Con[rac[or or OwnerMaking Inslellation)
7-1(? 5i-I&.'j t?- A- .?1 M N 5510 ?
Au[honzetl SignaWre (Con[ractor/Owner Making Installation)
fi?ilbb WC?d,-V Phone Number
ZZ`f -2z 3
MINNESOTA STATE BOAPD OF ELECT CITYG
Gtlgga-Mltlway Bltlg. - Raam 5-126
Dn
II
II
I
? I
? I
I
I I
I
I I
I
II
I THIS INSPECTION flEOUEST WILL NOT
BE ACCEPTED BV THE STATE BOARD
?
1821 Univenity Ave., St. Paul, MN 5 0
Phane181216G2-0B00 UNLE55 PROPER INSPECTION FEE IS
ENCLOSED
s
cy?REQUEST FOR ELECTRICAL INSPECTION s-ooooi o
5?9?95 ' ?? Seemstmdions br compleeng Ims form on back of yelb?.v ropy .? ???Q
"X" Be/ow Work Covered by This Request \'??
Add Rep ' Type of Building Wired Equipment Wired
Home Fiange Temporary Service
Du lex Waler Heater Electric Heating
Apt. Bwlding Dryer Load Managament -
Comm./Industrial Fumace Other Specify)
Farm Air Conditioner
Other(specity) Conhaclors RemaMS . ? I Oo A -to w ako kxc
Computa Inspechon Fee Below: .
k • Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
' Swimming Pool 0 to 200 Amps ,oa 1 I 0 to 100 Amps 5? ao
Transformers Above 200_Amps I Above 100 _Amps '7.oD
Si ns inspeciors use oniy TOTAL
Irrigation Booms Q?
7)_ -7-7, -rjQ
Special Inspection
AlarmlCommunication DISCONNECTED IF NO7
7HIS INSTALLATION MAY
• Other Fee COMPLETED WITHIN 18 MONT .
I, the Electncal Inspector, hereby Rmqn,o oa?' ?? wy ?
ceRity that the a6ove inspection has
been matle. F??ei ?a?e ? y f
OPFICE IISE ONLV
This request voi0 18 months from