3819 Danbury Tr - Electrical Permitsfrom'd
223
ryoW E] Will Nolify_ Inspec-
tor When Ready
Licensed Electrical Contractot 1 hereby request inspeccion of a6ove
4-1 Owner electrical work installed at:
MINNESOTA STATE BOARD Of ELECTRICITY
GrigSg.Midwey Bldg. - Room N-191
1821 Univarsitv Ave.. 51. Paul, MN 55104
Phone (612) 642-0800
BE
?
IS
REQUEST FOR F,' ECTRICAL INSPECTION ? Eg-00001c-06
1 See instrucLons for completing this Iwm on back of vellow copy.
l
1"% 7 fl r) 7o "X" RPlnw Wark Covered by Thrs ReQuesi
LJ J
dd VL
ReD• LJ
TYDe of Building
ApplianCes Wired
EquiVmenl Wired
Home Temporary 5ervice
Duplex Heater Lfghtin,y Fixtures
Apt. Buildinc? F Electric Heattn
Commercial Bldg. ce Silo Unloade.
Industrial 81dg. onditioner Bulk Mflk Tcnk
Farm Ocn?? vec? y iher ISP?'r.ifVl
t er Vecify Other Other
I.UI1
M 1jJL1lC JrIJ
Fee JJC?uvrr r cc -vrr
ServiceEntranceSixe
fi
Fee
Feeders/Subfeeders
f?
Fea
Circuits
0 to200Am s Oto30Am s Oto 30Am s
Above 200 Am ?s 31 to 7 00 Amps 31 to 100 Am s
Swimming Pool Above 100-A?iPs Above tOd_.Amps
Transformers Irrigation Boorns
AFV p
Other F-ee
Signs Special Inspection $/t TOTAL 71
E l(?G?
OD me.Lc ?`? I S
I, the Ele '
Rough-in Date
Inspector, hereby
rlily lhat lhe ahove
Final ? ??Pection has been
Thls request rald 18 montha lrom
7hi5 re9uest void ?W?I??3l?O
rrpnths /rom
18 /1 /
{
030224 , 1 A, , W
R
gqyest I]ate ??
??(? j ?
Fire No.
Rou -m Insper,bon
epwrad>
c?/oL
?Heady NowWill Nouty Inspec-
? ? N Wh R dY
Licensed EIecV.cal Convactor
I hareby reQUast insoection af ebova
Owner alactnwl work in.culiwn a,
REQUEST FOR ELECTRICAL INSPECTION ea-ooooi-os
. ? See msiructions for campleUn this lorm on back ol L ?
7(?) 9 yellaw caOY.
0+3U`L 2 4 "X Below Work Covered by 7his Request
dJ Rep. Type ol Building ApPlisncae WveE EquiUmem WveA
Home Range Temporery Service
Ouplen Water Heater Lighbng fixtwes
Apt. Bwlding Dryei Electnc Heatin
Cominercial Bldg. Furnace Silo Unloader
Industnal BIAg. Air Condinoner Bulk M, Ik Tank
Farm ort,Nr SpNr,ifv Other lsucr,FVl
t?er Sue?,ifY Other OthHr
`-vrupwe Jnsueciron ree eeiow
k Fee ServiceEntranceSize n Fee aders a Fea Circui?s
0 to 200 qm s 0 m 30 Am s
Above 200 qmps s 31 to 100 q 5
Swinxning Pool Amps
=100-Amps Above 100_Amps
ms Pertial/Other Fee
ction
$ ?-
Remarks
? s OTAL FEE
/ - . G7/
i /
Rough-in t ?. ? / e? I, the Eleciricxf'
U
Inspector, hereby
certrfV <hat the above
F??al
Zur r Oate ipgpeclion ha5 Eeen
? ? fQ ?? mede.
This reauest void 18 montlss Irom
1821 Universitv Ave., St Paul, MN 55104 UNLESS PftOPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
4?/ ??y'y
M40622
R 80/?
equestoate
j ne No Raugh In I psecbon p re?
(You musl call insp o hen reatly)
? Ves IngpecM1On OtM1er Than qougM1-In
? Reatly Now ? Wni Not?ry mspeno.
o pate Reatly
I hcensed contraclor ? o
wner hereby request mspection of above el
Job Atltlress (Streel
Bo ectrical work at.
,
x or Route No )
3cr51q -DAQ Bu,p,`{ --j-1R19 I l
cnyr
-
Section No Township Name or No l.. •j
Fan9e No Counry
Occupanl(PqlNT) (A k O r14
t.-F,E,Y t 1 -e- Ev ?nN?Un
Li? t Phone No
Fower Suoolie? LL '??v - 1-7
- -' L+i-nnvr_ ry I G jA/(1 " L: rCf' ING Coniractors License No
135E2 CENTRAL AV?. N.E. /1 ? ?O, n p?
qd
Madmg Oress (Conv??or ol OwnerMaking Installauon? ? ` ? ?
Auihorrzea Sgna?u rComra?
wner Mpking Insial?lon)
Phone Number
MINNESOTA STATE BOqRD OF ELECTqIQTY I? ?? ?? v v
,
Gfi99s Mitlway Bltlg - qoom S473 ?? THIS INSPECTION REOUEST WILL NOT
1821 Unrverstly Ava, St, paul. MN 5510< BE ACCEPTED 8V iHE $TATE BOARD
Phona (812) 861-0800
t1NLESS PqOPEF INSPECTION FEE IS
ENCLOSEp
4?W 7/y? REQUEST FOR ELECTRICAL INSPECTION ¢7
0 4 0622 Sea insvuobone lor romplatinq tM1is brm on back of yellow oopy ar??? EB-00001-OB
'X"Below Work Covered by rhis Requesf .,ogI? aedl
Heater
Compu? te lnspection Fee Below.
Remarks
-- ree
SWimming Pool # Sermce EntrenceSze
Fee ?F Circmts/Feeders F
Transformers e
0 to 200 Amps 0 to 100 Amps
5igns A6ove 200 _ qmps Above ?00
- Amps
InspecNr's Use Onl
Irngahon BDOms y
= - TOTAL
Special Ingpection
Alarm/Communication ?
Other Fee TFiIS INSTALLATION MqY BE?ORpERED DISCONNECTED IF
CO
I NOT
MPLETED WITHIN 18MONTHS
, the Electncal Inspect
or, hereby .
Rougn-?„
certty that ihe above inspection has oate
been made Fi^ai (
IFFICE USE ONLY De
?
his request voitl ig monihs from
- /