1977 Jan Echo Tr - Electrical Permits0 «-(C>J% Y 7YREQUEST FOR ELECTRICAL INSPECTION
See mstmctlans tor camplelmg Inis form on back of yellow copy
"X° Below Work`Covered by 7his Request
=%x
=_'?o??Z'd'OG/
Ne Add Rep. Type of Building Appliances Wired Equipment:NFre9>>
Home Range Temporary Service
Ouplex Water Heater Electric Heating
Apt Building Dryer Load Management
Comm./Industrial Furnace Other (Specify)
Farm Air CondRioner
Other(spectly) Conlreclors Remarks 10 oA To??n
Compute lnspechon Fee Belaw:
# Other Fee # Service Entrance Srze Fee #
j Cvcuits/Feeders Fee
Swimmin Pool 0 ro 200 Am s 0 io 100 Am s .aD
Transformers Above 200 Amps Above 100 -Amps -)r00
Si ns mspaocrns use ooiy - TOT
A
L
Irrigation Booms 7
? / •U? -
7
? [ , ??
Special Ins ection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 1 NTH
I, the Electrical Inspector, hereby
tif
th
t th
b
i Rougn-in ? Da[e
cer
a
y
e a
ove inspect
on has
6een made. F,nai ? oale
OFFICE USE ONLV
This reQUest void 18 months fram
°°? ?
0?
5-975 ?
a- 9
U al, 7
R441st Oa e Fire No ovyh=ln ec ion Req
(VOU call inspecror hen reatly)
? Inspection Other Then oughln
0 Reatly Now YlAI No6ty Inspector
Yes
Na D.I. Reatly
Iklicensed contractor ?owner hereby request inspection of above electncal work at:
JoblAdtlress (StreBt 6ax or FouNO )cc/h ? I
a
? J CitY
?? C'm
Sec[ion No TownsNp NHme ar No Range Na Counry
cc ?0
an?(PRIN'f)
u??t? ?s Phone No
sz-szDo
Power SupP6er Atltlress
Zo
EI c[ncal Contractor (COm a y Name
?lins -?. s?-. Co . ConVacror's Licensa No
CA myo
Maihng Atld ess (COnVactor or Owner Makm Installahon) ? ??
7
Z?S ? ?-rec. N 10
Authorizptl SignaWre (COnVactm/Owner M king Installallon)
?b W? Phone Number
ZZq -2-9 33
G?99UO e el y l Ava. 8 ? Pe OF R f I ? I II II I I II I I III I 11 I I II III ENO T
OSED OPER NSPECTIONF EE $
Phone (6@) 69P-0800 ? ??
REQUEST FOR ELECTRICAL INSPECTION es-ooooi/-o/s
10, See msiructions foi completing ihis farm on back af yellow copy e`4 Fi ?S(JT
"X" Be/ow Work Covered by This Requesf
Ne Add Rep. Type of Building Appliances Wired Equipment '
Home Range Temporary Service
Duplex Water Heater Electric Heatin
Apt. Building Dryer Load Management
Comm./Industrial Fumace Other (Specify)
Farm Air Condrtwner -
Other (speoily) Contracto/r'?s R/e?m?erks 1?W? \Y\? ?.
Compute Inspection Fee Below: I0V1?
# Other Fee # Service Entrance S¢e Fee # Circuits(Feeders Fee
Swimmin Pool l 0 to 200 Amps $, 00 0 to 1 DO Am s 5Jo
Transformers Above 200 Amps I Abov" 00_Am s "7, co
Si ns inspenor's use Onty. TOTAL
IrrigationBooms 77„Ov ??,Sb
Speaal Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORD DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 1 ONT
I, the Electrical Inspector, hereby
tif
h Rouqn,n ? Date
cer
y t
at the a6ove mspection has
been made. Final / oa?e
OFFICE USE ONLY
This request voitl 18 months tro.
O
??s 69 0 ?
? ? ??
a
,
Reql
}? /7
^"
( - Fire No ugh-In I ecfion Reqw
(Vou u II Insv=ctorr w?hen reatly) Inspechon Other Than ugh-In
? Reetly Now Will Nolify Inspeclor
?/
I Ves u No Date Reatl
I x licensed contractor ?owner hereby request inspection of above electrical work at:
JoG Atldren (Sheet, eox or Rome No ?
?q , o?e? ??r Ciry
Ea
Sedion No Township Name or No Range No Gounry
AaAo
Occup/an/l?PRl T) P(h?oeNo
pr
I Ji-sz O ?
Power Supplier
I? ?i `Ki ?IQC4'7G Atlaress
`?3(?0 ZZD'Ii1 CJf1'?C(?" (5
E qrical Conttatlor (Cm
I
Co 65 any Name) '
C+Vi (c-l (?oY) 6. ConVacrors License No
.
vo?f o 1?
Maihng Address (Conhaclor or Owner Ma1king Installahon) IA h '
? ? I IV`1V ??jL)
Authorrzetl Signature (COnlraclorlOwner Making I slalla0on)
b Phone Number
2- Z3 33
MINNESOTA STATE BOARD OF ELECTRI THIS INSPECTION REQUEST N11LL NOT
P u ?MN $S10?M1? gE ACCEPTEO 6Y THE STATE BOAFD
B21?tln ve sRy Alve., Room
Phone (812) 642-0800 ?/ FUNLESS NCLSEpOPER INSPECTION FEE I$
0-l05 - ?7?
i0??Ifv
REDUEST FOR ELECTRICAL INSPECTION ° '? ?es-Sogopi-oy
? See instmctions for completing Ihis form on back of yellow copy ??d??f
"X" Below Work Covered by 7his Request
Ne Add Rep. - Type of Building Appliances Wired . Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
- Comm./Intlustrial Fumace Other (Specify)
Farm Air Conddioner
Olher (speafy) Conlrador's flemarks'
I 0 0 F? Tao-n? ??
Compute Inspechon Fee Below'
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool ? 0 to 200 Amps IfS,601 (11 0 to 100 Amps .00
Transformers Above 200_Amps ( Abov 100 _Am s , W
$IgnS inspectors use Only TOTAL
Irrigation Booms ? 7' -7 -7, SQ
Special Ins ection
Alarcn/Communication THIS INSTALIATION MAY BE O D E4 DISCONNECTED IF NOT
Other Fee COMPLETED WITHI 8 ON
I, the Electrical Inspector, hereby
i
h
h Rough-in ? r oaie
ry i
at t
e above inspection has
cert
been made. F?nai p
i oate
OFFICE USE ONLY
This requast witl 18 monihs imm
0= p? vQ76 ?
? ? ? ? ?
?
Requ t Oete Fre No ough-In ec?lon 9e Inspection Other Than ough-In
(VOU u II inspector when ready) ? Reatly Now Will NoLly Inspector
- ?30" Ves ? N. Date Ready
I licensetl contractor ?owner hereby request inspechon of above electrical work at
Jo4 F ress (Street, Box or Route Na
iq?q ?o?h ck) -fra i Qly
Ec? CA,
Section No Township Name or No Range No Cp\unty 1
Oc ani (PR NT7
?u c? Phone No
-S o
Power Supplier
. ? 'le hri Atldress
o- z 5?-. W-es--?
Electnr.ei ConVec[or (COmpeny Name) •
II . Elem? al Co ?tu??tbh Gontredoi s License No
C+?oo otO
Mailing AtlCress (COntraclor ot Owner Meking Installalion) Z7 8 5 ?-e, 5?r?e?- S? .?GU•?. I I?l N 6S)67
AuthonzeE SignaN In Ilation)
T)Zk re ( oniraclor! wner Maki -?m? Phone Numb r
Z2?-Zg33
MINNESOTA STATE BOpRO O?T??
Grtggs-Mitlway Bltlg. Room 1 I? III I I I II I I I I II ?I I I (I THIS INSPECTION REQUEST WILL NOT
eE ACCEPTED Bv THE STATE BOARU
1821 Univerolty Ave., SC Pau , M 5
Gbnnn IBt9\ PG9lIM11 UNLESS PROPER INSPECTION FEE IS
FNCI (lAFfl
E?.o?-
REQUEST FOR ELECTRICALINSPECTION
v See Instmctwns br complenng this form on back ol yellow copy.
?
"X" Be/ow WorkGbvere,d by This Requesf xC?L
. R°?-?-??___
Ne Ao`d Rep. Type of Bwlding Appliances Wiretl Equipment ved
Home Range Temporary Serwce
Duplex Watar Heater Electnc Heatin
tBuilding Dryer Load Management
l t
mm./Industrial Furnace Other S acify)
rm Air Conditioner
er (speclty) Contraclor's Remerks'
Compute Inspecfion Fee Below: IoD Ill -T-O c KIL-?
N Other Fee # Service Entrance Size Fee # CircwtslFeeders Fee
Swimming Pool 0 ta 200 Am s •op I, 0 to 100 Amps 5,60
Transformers Above 200_Am s , Above-j 00 -Amps 7 00
SI nS Inspector's Use only TOTAL
Irrigation Booms -77 0
Special Ins ection
Alarm/Communication THIS INSTALLATION MAY ORDE D/615?ONNECTEO IF NOT
Other Fee COMPLETED WITHIN 7B ?HS.
I, the Elecirical Inspecfor, hereby
nif
h
h
b
i
i
h Rough-in . ?e
ce
y t
at t
e a
ove
nspect
on
as
been made. F,nai e
OFFICE USE ONLY
This requesi void 18 mon[hs from
5 m 9 7 ?094
0 -1
?
?
RequBSt ate Flre No, ough-I pectlon fl rt Ins eclion Other Tnen qough-In
(YOU cail inspeclor when reatly) ? Reedy Now Will Notiy Inspeclm
Ves ? No Date Reatl
I licensed contractor ? owner hereby request inspection of above electrical work at:
Job Address (SVeet, Box or Route No.)
40 arid CLr cl e. Qty
Ec.a
Section N. Township Name or No Renge No. Counry
lJ? 69 +-C(
Occu ent(PRIN?
U Pnone No
45Z-SZD O
Power Supplier
a.Ko I ??-?? Atltlress
-220 5?r?eet- w-ts-4-
EI ttlcel ontrector (COr?p y Name
!? n5 ? e-? ?,l ` Co ?s-?. Conirector's L?cense No
CAoo L- oU
Maihng Atltlrass gnlracror or Owner Making Inslallatmn)
Authorizetl Signature (COniractor/Owner tdaking Insl Lon)
?? 2 v??i Phone Number
2Z?( -2.S 33
MINNESOTA STATE BOARO OF ELECTFIC ,n
Grigge.Mldwey Bltlg - Room 5448
'
II THI$ INSPECTION REQUEST WILL NOT
BE ACCEPTED 6V THE STATE BOAFO
1811 Unlvttafly Ave., Sl Peul, MN(5
S (?fTC
Ghone 16121 642.OBIIO k V UNLESS PROPER INSPECfION FEE IS
cnin necn
?41*917Z
C/ 7,7REQUEST FOR ELECTRICAL INSPECTION
? 10- See mstmcnons for rompleting this torm on back oi yellow copy,
"X" Below V?ork Covered by This Request
e- o i-os
.? o
??s?•- ?"- -
Ne% Add Rep. Type of 8uilding Appliances Wired Eqwpment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Fumace Othar Spea )
Farm Av Condrtioner
Other (specdy) ConVaotoi s Remarks' {-
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circwts/Feeders Fee
Swimmin Pool )l 0 to 200 Amps s o0 1 11 0 to 100 AmpS . od
Transformers A6ove 200_Amps I Above-t0 _Amps 7uc00
Si nS mspecmrs use Oniy , '
), TOTAL
Irrigation Booms CC -7-7, -?J- Q
S ecial Inspection
Alarm/Communicahon THIS INSTALlATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN MONTIJ& (
I, the Electrical Inspecior, hereby Rough-in oate
certify that the above inspection has
been made. F,nai J ?
-? oate
OFFICE USE ONLV
This requesi voM 18 months fmm
0- 0
?977
? ?t, ?oy?
`
6,0
9 u 9 77
/ >
Rel Date
--3O Fire No ou?,r-la :[ion Req etl Insper,tion Other Thugh-In
(VOU u call inspetlor when ready) ? Reatly Now Will NoUfy Inspec[or
Ves ? No Da[e Reatl
I? licensed contractor ? owner hereby request inspection of a6ove electrical work at:
Job Mtlress (Sire I, Box or Route N)
a?81 an
ko
a,.i I Ciry
Section No Township Name or No Fange No C unry
1 /?V 1 t?
OLC an?l I T? ? ? Phone Na S? SZD Q
PowerS1Uppber Atltlress l/..`? 1I {p
?3DO-??0? V?. VVIJ?
Elecmcel Contractor (COmpany Name)
"
l
?. CD. Con[rector's 4cense No
GAOC otQ
Maihng Addrass (GOnlractor or Owner M king Install tion)
?lg e?-
Authoriietl SignaNre (ConVactodOwner Making I all n)
? ?m Phone Num?er
MINNESOTA SY ATE BOAHD?? IZYy? I
Gtiggs-Mltlway Bltlg. - Raom ?
w II I I II I II I I II I ?I II II I I THIS INSPECTION FEQUEST \NII L NOT
BE ACCEPTED BV THE STATE BOARD
1821 Univerell Ave., 51. Pa I,
Phonef612160R-OB00 UNLESS PFOPER INSPECTION FEE IS
ENCLOSED
Q(?f 5?'-7 (REQUEST FOR ELECTRICAL INSPECTION ?? 9es o0 01 -0 / ( ? See insVUCOons for complelmg Ihis form on back ol yellow copy. ? i}Q?
"X" Be/ow Worls Covered by This Request
Ne Add „ Type of Building Appliances Wired EquipmenfV9fred=
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Bwlding Dryer Load Managament
Comm./Intlustrial Fumace Other (Specify)
Farm Air Conditioner
Omer (speaty) CoMracmrs Remarks ? ? q
Compute Inspechon Fee Below: J A ?O ?n? D M1l"?-'
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimmin Pool 0 to 200 Amps ,pp 111 0 to 100 Am s co
Transformers Above200_Amps Aycve 00-Amps ,o0
51 f1S Inspecror's use Only TOTAL
Irrigation Booms 7-OV -7-7.60
5 ecial Inspection
AlarmlCommunication THIS INSTALLATION MAY BE OR R D PISCONNECTED IF NOT
Other Fee COMPLETED WITHIN =NUDNT ?
I, the Eledrical Inspector, hereby
tif
ih
t th
b
i Roughin ? oate
. cer
y
a
e a
ove inspect
on has
been made.
F'"af7 7/3 a')WY . _ /1
"?
Date
OFFICE USE ONLY
ThIB rPquesi Vad 18 mOnlhB fmm
Feque 1 De4_
!? ? Fre No ough- n ectmd quvaC? Inspection 01her Than ugh-In
(YOU ,
cell inspeclor
when
raetly) ? Reetly Naw III Nobty Inspec[or
??
(J Yes
?
nate Read
No
I I?] licensed contractor ? owner hereby request inspection of above electrical work et
Job AOEress (Sireet. Box or Rout No )
+'?a.cl c
Q'g2 Ov?
l? City
E
,
, 2-Qallq
Seqion No Township Name or No Range No C?ounty? ?
V`-'..
?upanl1P?NT) ?? Ph?eSZ??VO
Power Supplier 1 ? L^'J? -f?'?/?(
1/VkKO ' Li V l'L?1' Il? ? AtlCre?ss
Eleclncal Contracror (COmpany Na
?
?
? e)
?-
C
' Coniractor's License No
C14-?0?(
b
?h .
eC b
•
o CU
Matlmg AtlOress (Cmhactor or Owner Making I?stallaLOn)
2 -lu,?e ?-ee?- 54?,Pcu,-f' MN S6Io7
Autnorizetl SignaNre (COnlractoriOwner Makm9lnst )
306 ,A,(? m Phone Number
zzq-ZS 33
Gr STATE
1821 Oniverslly Ave., SC Paul, MN 55?OD '? UNLESS PROPER MSPECTION FEE IS
ggs-MldwayBtlg 8 Room 5428E( ??v? 11111111111111111111111111111111111111111111111 ENCL03Ep EO BV THE STATE BOARDT
Phone (612) 642-0800 ?
???? REQUEST FOR ELECTRICAL INSPECTION _ _Q1 y
? See msvucuons for completing this fortn on back ot yellow copy U
"X" Below Work Covered by This Request +. ??,• ?
Ne% Add Rep. Type of Building App4m'7ices Wired Equipment Wired
Home Range Temporary Service
- Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Fumace Other S eci )
Farm Air Conditioner
Other (apecity) Contracfor's Remarks
Compute lnspection Fee Belaw: 10 A, ?O w?A VI D I p vn?,,
# Other Fee Jt Service Entrance Size Fee # CircuitslFeeders Fee
Swimming Pool ? 0 to 200 Am s 1l-?. b0 V I 0 to 100 Amps ? DO
Transformers A6ove 200 Amps I Above 100 _Am s , o0
- Si f1S Inspector s Use only. TOTAL
Irrigation Booms 1l-? 1 T , j c?
Special Ins ection .
Alarm/Communication THIS INSTALLATION MAY BE ORDE
DISCONNECTED IF NOT
Other Fee (
COMPLETED WITHIN ONT .
I, the Elecirical Inspector, hereby R°"qh-'n
certify that the above mspection has
been made.
F'"ai //, ?
Dale
OFFICE USE ONLY
This requesl voitl 18 months irom
178 ?S?SO?f
?o? ? R;
Request Date
j? re ughdn c0on R
(YOU .& mspector when ready) Ins ecUan OlharTnep f7oughln
? Reatly Now PIA, In Notity Inspecmr
Ves ? No Dete Read
I l?]ticensed contractor ?owner hereby request inspection of above electrical work at:
Job Address (Sireel, Qox or Route No?
Iqg3 Jftn e
Trai,( Ctly
6a a,h
Sectwn No Tawnship Neme ar No Range No Counry
D crl--
Oc pant P INT) Phone No
ySZ SZ,ao
ower Supphar
M
-?ri c? Atltlress
y30o-- .C)% 5+ . -?
E ctncal Convactor (COm ny Name)
I
`
? Con[rac[or's License No J?
1?. ?C I YLJ ?o V
Maihng Atltlress (?1 ec?or o? ner Ma ing Inslal?? ?
?
?
S 5J' 0?
?N
?
,
? '
Amhonretl SignaWre (Comrac?or/Owner Makin Inst letion)
'1r?1 Phone Number
22 -7?33
G999 UNva elry Ave, StR. P u SME 5?R' II III I I IIII III II I I? I I I I III ENC OSED.OPER INSPECTIONF 6EpST
Phone(812) 6C4-0800 ???N ? ?
UEST FOR ELECTRICAL INSPECTION ee-pp11-os
mstruc0ons for completing ihis brtn on back ot yellow copy. EI ?
"X" Be/ow Work Covered by This Request
Ne? Add Rep. Type of Building ApH. .s Wired Equipment WrreB_
Home Range Temporary Service
Du lex Water Heater Electric Heating
Api. Building Dryer Loatl Management
- Comm./Industrial Fumace Other (Speciry)
Farm Air Conditioner
Other (speclfy) Con[ractor's Ramarke I A ,?1
Compute lnspectlon Fee Below:
tf Other Fee # Serwce Entrance Size Fee # CircuitslFeeders Fee
Swimmin Pool 0 to 200 Amps I s,GO ! ? 0 to 100 Amps S.vo
- Transformers Above 200-Amps Above 700 -Amps 7, GY)
Si 09 Inspectars use Onry TOTAL
Irrigation Booms ? 7, pU ",, CJ- Q
Special Inspection
Alarm/Communication 7HIS INSTALLATION MAY BE OR DISCONNECTED IF NO7
Other Fee COMPLETED WITHIN 18 OfiTHS. (
I, the ElecMcal Inspector, hereby
tif
th
t th
i
6
i
h Rough-In 610 ,, aie
cer
y
a
e a
ove
nspect
on
as
been made. Final .
OFFICE USE ONLV
This request voitl 18 manth5 hom
0-
0
?
Requ t Dat Fire No ou h-ction R ve
(YOU apector wnen ready)
? Inspection OtherThan ough-ln
? Ready Now Will Notily Inspeclor
No Dale ReaO
I licensed contractor ? owner hereby request inspection of above electrical work at:
Job Atltlress (Slreet. Box or Route No )
od ' Cny
?c ?-
Seclmn No Township Name or No Range No Counly ?
Oc?pant (PR ?
rLAA Phone No.
Power Supplier
tua- ?? Atltlress
Iti1-?S?-
Electncal ConVador (COmpany Name)
1ins le ( Contractors Lmense No
Os?. Co. cNoo o(p
l71alLng Address (CO a
? tor or Owner Making Installatron)
t? S-1-Yee
.-F _ aw-l 64 (\,?f SS 10-7
rluthorrzetl Signature (ConlradodOwner Mekm Install lion) Phone NumGer '?
ZZy- 33
?t
MINNESOTA STATE BOARO OF ELE TF I THIS INSPECTIO:J REOIlEST WILL NOT
tt'
S2?-. p 6E AGCEPTED BV THE STHTE BOAHD
Gdggs-MlOVray Bltlg - Room -0
1821 Ilniverslly Ave., SL Paul, MN @S?q`? I UNLESS PFOPER INSPECTION FEE i5
Ppone 16121 642-0800 U- V??,I ENCLDSED
REQUEST FOR EIECTRICAL INSPECTION
'$ee mslmctions for completing ihis form on back ot yellow copy
"X" Below WoFA.qWed by This Request
Ne 'Add Rep' Type of Building Appliances Wired Equipment Wire
Home Range Temporary Service
Duplex Watar Heater Electnc Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (Specrfy)
Farm Air Conditioner
Otber(speclty) Contracbrs Remarks: - AO
?O " r'n???n ?vw
Compute lnspection Fee Below: 160 A
# Other Fee # Service Enirance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps , np ( 0 to 100 Amps , W
TransFormers Above 200 Amps Above 100 -Amps 7.00
Si nS Inspector's Use Only/ TOTAL
Irrigation Booms 0J -77, SQ
S ecial Inspection
Alarm/Communication THIS INSTALLATION MAY BE O 4 DISCONNECTED IF NOT
Other Fee ' COMPLETED WITHI TQVION
I, the Electrical Inspector, hereby
h Rou9n-in oate
e above inspection has
been made1 Final /" y oaie
OFflCE USE ONLY
Thrs requestwid 18 monthsirom
E0r?S?
??Qt
0-? --79 ?
R st Dat Fve No Rough- c Re
(VOU u a, per.lm when reatly) Inspeclion Other Than ough-In
? R9atly Now Will Notify Inspecbr
)
Ves ?No peteFeatl
I-?licensed contractor ? owner hereby request inspection of above electrical work at
Job AdCress (Slree,. Box or PoNe No
5 c?.n ? i? i I Ciry
Ea a
Section No. Township Name or No Range No County ?1 ?
O
p
am ( P INT)
E
Phone No
ySz SZ?o
Powe
bADVp- r Sup ier (
c/
Atldress ^-7
/'` ?
V ? . . +
E(le'?ctncal ontrector(Cojmoe?ny Name\) f
? Conrca/c'+loYS Lmense No
W
OO O
l?
MaAmg Address (C mr ctor r Owner Makin Instelislio p
QU
l M N S10_7
?- SV
A_
,
? r-ee
Authoraed Signeture (ConiractonOwner Mak'ng Installafi ? Phone Number ?
2100 _ v,lj'? t ZZy-283
% ??? THIS INSPECTION REOUEST WILL NOT
Or ggs-MIC ey Bldg B qoom S 1 ?
Phone (61Y) 602-0800 II II I I II III I I II I I I? II BE AGCEPTED 0V THE STATE AOARD
1821 UnivenRy qve, SL Vaul, M 5 UNLESS PROPER MSPECTION FEE IS
ENCLOSED
?ou -773REQUEST FOR ELECTRICAL INSPECTION g?e-e/-aoooi-os
? See inslmc0ons lor compleling Ihis form on back of yellow copy {?ll? ?
"X" Below Work Covered by This Request _w- 1 3 q _3 5
Ne Add Rep. Type of Building v, pliarlDes Wired Eqapment Wired
Home Range Temporary Service
? Duplex Water Heater Electric Heating
Apt Bwlding Dryer Load Management
Comm./Industrial Furnace Other (Specify)
Farm Air Conddioner
Olher (specdy) Conlratlor's Remarks
Compute Mspection Fee Below' I O01?
N - Other Fee # Service Entrance Size Fee # CvcurtslFeeders Fee
Swimmin Pool 1 0020 0 Amps S,oo 11 0 to 100 Amps fio
Transformers Above 200_Amps Above 700 -Amps 6C7
Si n5 Insvecror'sUSeOnry, ? TOTAL
Irrigation Booms 1??C?j `]7, S?
S ecial Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERE DISCONNECTED IF NOT
. Other Fee COMPLETED WITHIN 1 THS (
I, the Electncal Inspector, hereby
rtf
th
h Rouqn.m ?
r ? oaie
y
ce
at t
e above inspection has
been made. Fin.i
OFFICE USE ONLY
This repuest wid 18 monfhs irom
7 3 F9?
??
s S
Fequ t Date
1 Fire N RougF, nspecno etl Inspection Other T?e?ugh-In
(VOU IPmspec?or When reatly) ? Reatly Now Will No1Ry Inspeclor
Yes o No Da?e ReeG
I?licensed contractor ?owner hereby request inspection of above electrical work at:
Job Ad/tl?re?ss`I(Str,,eeG Box` oIrU Royu?te No)
•I`7 O lY D V ?.? l V ? CA?y ?j
l.r? c.l
SecOon N. Township Name or No. Range No Counly (
Il-o I w
Occu nt(PRINT
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Power Sup0liei
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Elecfncal Conirector (C pany NaIme)
? 11 5 T. Contraclor's License No-
Mailing Atldress (CO?ct I L`?/
?wner Maki I stall?,?) C I M„
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ANhorrzetl Signamre (COnlraqor;Owner Makmg Inslall mnl)/? 1^^ Phone Nu?m(pe,
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MINNESOTA STATE BOARD ITY
Gdggs-Mitlway Bldg. - Roam
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I THIS INSPECTION qEOt1EST WILL NOT
II BE ACCEPTED BV THE STATE BOARO
iffiI University Ave, St iaul
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Phnnw IF191 PAMMO11 9 . UNLE55 PPOPER INSPEC710N FEE IS
FNf.I ORFfI
REQUEST FOR ELECTRICAL INSPECTION
10- See instructrons for compleung this lorm on back oi yellow copy. - 4?
"X" Be/ow Work Covered iy This Request
Ni Add Rep. Type of Building Appliances Wired EquipmentAfJired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (Speafy)
Farm Air Conditioner
Other(speciy) Contractor's Remafrk?s' ?/V? l.V \v'? 1^ O
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Compute lnspection Fee Below: 10 0 I? 1O 1
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimmin Pool ' 0 to 200 Amps (?j, 00 I( 0 to 100 Amps oc;
Transformers Above 200_Amps Above 100 _Am s-7_oc?,
$' p5 Inspedors Use Only TOTAL
Irrigation Booms ti ' -77 , S/?
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Speciai Inspection
Alarm/Communication THIS INSTALLATION MA BE O D PISCONNECTED IF NOT
Other Fee COMCLETED WITHIN NT
I, the Elecirical Inspector, hereby Rouyn-in ,
? ? oate
certity thal the above inspection has
been made. Flnal
o ete
OFFICE IISE ONLV
Ths request voitl 18 months irom
0-I,,aa 9 7 9 8 0 ? ?.?, ? ?-so5u
Requ t Det
? I?? O` ? Fire No. Rough-Iq.i ction Requ
(Vou u t I mspec5or?han reatly) Inspection Other Than gough-In
? Raetly Now S?Will NoUty Inspeclor
es No Date Featl
I? licensed contractor ? owner hereby request inspection of above electncal work aC
Job Atltlress (Straet, x or Poute No )
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Secbon No Township Name or No. Range No unry
Occ nt?PRiN Pnone No
Pawer SuOPlier
Y?/ C?C Atltlress
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learical Contracmr (Gompe Name) Con/lr'a?nors Lmense No
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A?}tl^O(?ress (COnvactor r Owner Makin Installation)
Mailin
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Authonzetl 3igpneture (Canireator/Owner Makmg Inslsllal' n)
? Phone Number (??
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MINNESOTA STATE BOARO E E Idj?
Griggs-MlEwey BIEg. - Haom?S
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? THIS INSPECTIDN REOUEST WILL NOT
BE ACCEPTED BY THE STATE BOARO
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1821 Universlry Ave., St. P6W,
Phone I6121692-OBW \
, UNLESS PROPER INSPECTION FEE IS
. ENCLOSEO
0 ° 0
7 4 k
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" $
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-77
Request afe
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- Fire No Poughln+n eetlorFFe
(VOU call inspector w?en reatly)
u Inspection Other T n ugh-In
? Ready Now WAI NoNy Inspector
I ves ? Na oate Reatly
IIx licensed contractor ? owner hereby request inspection of above electrical work at:
Job Atltlress (Street, Box or Route No )
88 G?.v? ?Ji C City
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Sec[mn N.
- Township Name or No Fange No Counry
t)a
O- pan?(P NT)
p??,ti? ?S Phone N.
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PawerSUppher
pg-K o-I-C,t- E,l.,eC-I-ri C. Atldress
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Elactncal Contractor (COm ny Name) /' ?
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?` Conlractor's Lmeose No
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M?? tldles5 (Cq(d clor0 ner kng Inslallalion1)?
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Authonzed SianaNre (ConVactodOwner Making Ilahon
? b -? c1?-PIns1 m Phone Number
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MINNESOTA Gr ggs-MltlwayTB tlg.B Raom SF128?T?` V1 ?I ? I ? 1111111111111111111 I I II I ENCLOSEO ED BV THE? STATE BOA OT
1821 University Ave., St. Vaul, MN 55 t?6? UNLE55 PROPER INSPECTION FEE IS
Phone(612) 692-0800 ??
/ Qf ?V7 EQUEST FOR ELECTRICAL INSPECTION B-00001-0
? See insimctions lor completmg this form on back of yelbw copy ???
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"X" Be/ow WorkjaZu?ered by This Aequest ?.
Ne Add Rep Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Du lex Water Heater Electric Heatin
Apt. Bwlding Oryer Load Managemenl
Comm./Indusirial Fumaca Other (Speafy)
Farm Av Conditioner
Otherspenly) Contradofs Remarks
Compute Inspection Fee Be/ow, I v0' ` TQ Wn; hb lll
# Other Fee k Service Entrance Size Fee # Cvcuits/Feeders Fee
Swimmin Pool 0 to 200 Amps '0 I 0 to 100 Amps rA
Transformers Above 200 Amps Above 100 _Am s 7.P 1
SI n5 Inspector's Use Onry , - TOTAL
Irngation Booms 7?-GY? 7? S?
S'ecial Inspection
Alarm/Communication THIS INSTALLATION M BE O ?DISCONNECTED IF NOT
Other Fee COMPLETED WITHI ONT
I, the Electncal Inspector, hereby Rough-in r f oaie
certiiy that the above mspechon has
been made. Final
s oate
OFFICE USE ONLV
TMs requast void 18 monihs irom