3869 Danbury Tr - Electrical PermitsThis requast vmd
S monih(s? imm
05- 0 el 72 $ 3
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Fen??cst Datc
1 Fire No.
I Fouuh-in,InsPecLOn `
Rrqwred ? ?pa
peaAy Now Q Wi II Nolify InsPec-
tor WNen Reatl
(S (? ?Yes 54NO Y
59 Licensed Elecincal Gontrector I hereby requast mspechon of above
? Owner qCl C3 f-) - f,'.1 '-? electncal work insislled at
SVee( Address. Bon or Route No. - _ City
F 6 /V
erunn o. Township Name or No. Ranye. No. County
v /r or
Occupant IPRWTI phone No.
Y 3 / 2Y
Power Suppher F+tldoess
6 C c% - _ 1?. ,v v
Elecincal Contrac[or (Company Namel Contracmr's Lwense No.
N-r c rr ? ?F c rp
Mailine /address IConVacmr of Owner Making InstailaLOnl
l 9 t/ ? M a h? vif- G / U-/y?N- S` o Y
re IConvactodOwner Making Installavonl
Authonzetl Signatu Number
Ph
o
ne
p /
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MINNESOTA STATE BOARD OF ELECTRICITV
Gnggs-Midway gldg. - Hoom N-791
1821 University Ava.. 5t. Paul, MN 65106
Phone (6121 297-2111
THIS INSPEGTION HEQUEST WILL NOT
BE AGCEPTED BY THE STATE BOAND
UNLESS PROPEH INSPECTION FEE IS
ENCLOSEO.
REQUEST FOR ELECTRICAL INSPECTION ea-oaooi.oa
?o',
?pj n
nt{ See ins«uctions lor completing this form on back of vellow copy.
-r ARI "X" Below Work Covered by 7his Hequest
laAd Xep TYOe of 8wlding Aaoliances Wired Equipment Wired
Home Ranye X Temporary Service
Duplex Water Heater LtghUng Fixtures
Apt Bwlding Dr'yer Electnc Heabn
Commerciai 81dy Fumace Silo Unloader
Industnal Bldy. Air CondiLOner Bulk M, Ik Tank
Farm oTnP, oec'ryl o1no? (SU??, fv)
thp.r GfClfy (J1hBr OIhgI
# Fge Service Entrance5ize, # Fee Peeders/5ubfeeders N Fee Circmts
l la. U 0 m 200 Amps 0 to 30 Am s 0 to 30 Am s
Above 200 qmF?s 31 to 100 Amps 31 to 100 Am s
Swimming Pool A6ove 100-Amp1 Above 100-A?PS
Transtormers frrigation Booms .5.0 Partial,'Other Fee
Signs SUecial Inspection -?
TOTA F
Remarks S'?" S E-K t/ r L.' E ??
Hough-in D,,te I, the tectric
Inspec e,aby
certdy thaA Ne above
Fnal ? j ?']lP G InspBC<iOn hds bBBn
?V'? meA¢.
I
thi5 reauest voitl 18 monlhs Irom
16 nwntp ast vmtl / L ?
from ?CI/ ,S?"+-C
Q G87884 ??
Request Dete
l0 /a s,s?
? Licensetl Electncal
C
Owner onimctor
? !„-.
Sheet Address, Bax or Roin> n^ ??
? ?.
"gh-in Inspe C
cb
quired, R E]
Neady Nuw
?Yes ?NO 29`Nill NnItV Inspeo
Ih Y
elecfr cal work rngjuPlletl a?'r xbove ,
4?a„'- lvmlNT? D9 !- o f?
R J ? ? Phone No.
Power SuPpher
r"T c t4 Add,PS= Y
Electncal Contractor (Compan?a?e)?
C ? / " ? I L ? ? - /Nmhactor'aLicense No.
MatlipgqddhresslC c+
Ontrecto ? ? ? y?
?/ ry ? or pH,qpr Mabng Installabon)
?f? p?
AuMonzed SigneEre (?n?i?r/p?0ak?ng Install??nl ? ? ? ? -
Phone Number y
kil
GrNNESOTA STATE BOAND OP ELECTqICITY ?? Q?
Phona 9gs-MitlwaV Bldg. - qoom N-191 THIS INSPECi1pN REQUEST
1821 University Ave.. SL Paul. MN 55104 WILI NOT
(612) pg7_z??? BE qCCEPTED B4 THE STqTE 60qRp
- UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
REQUEST FOR ELEC7RICAL INSPEC710N
84 See instryctipns for completirp this twm on back oF
Eg.00007.04
X ' Be/D Yellow copy.
y A?d qap w Work Covered by This ftequest
TYae of
X Home APAloacces Wiratl
Dupl?x Range Ea-iamene W?.ed
qPt. w'ater Heater Temporary Service
Bwlding ----?,_
Commercial Bldg. ?rnar,e ??ghhng Fixmres
lndustnal Bldg, Electnc HeaLn
Air Conditv,no. S'lo Unlpader
Far...
nyl Oth
= fseiow ?
I -ign,
/N.51A
Final
ihisleail-i3l .Id 11
Incesi:e p
Fee Fee
? S
-Am ?s ? to
ool 31
7 to
/
ion
S
Grcmtc
7 0 t0 30 Am?s
31 to 100 A s
Above 100_Am
. Partial.'Other Fee
TOiq- L ?
?U
?. the Elec ca1
Inspectol, p¢.eby
certify that the abowe
ineaecpon has baen
made: