3917 Danbury Tr - Electrical Permits
0) s?513 ??'? ? y?ap°"
Req est Date .? Fire No ?ugh-In Inspec0on Req rt Ins io er Than Rouqh-In
(V tly) ady Now ? Wdl Noldy Inspector
OU must call msAeclar ee
? Ves o Dale Ready
I a (c sed contractor ?owner herehy request inspection of above electrical work at:
Job Addal ( r p x or Raut a) ?M
/'
?' / ,L?'??" e
?L??t` ,{,
Sec4on N. Township Name or N. flange No County j
t
O<cupant (PRI Pnone No
? ??
?
Power5upp6er /
? Atltlress
Elecl(¢al nlrador (COmpa6y Name) CAm?reC/{o 's Lioense N.
ctor or Owner i Ins?elleVOn)
(COntrn
Madm AZ7
1
v ?
6
Aut nzetl Signa[ura (Conirnctod0 Makmg InGallalion) Phone Number
V
'C,TY
O O
RDT
I
Ve s ty FIVe.B p?P u SMNB 5104
GB99 0nl II I I II I I I I I I I I I I I II I?I I PROP ER INSPECTION P
SS
?I
E
PFnna lfi1 41 F69.ON00 S
EN
C
> REQUEST FOR ELECTRICAL INSPECTION
?
Il Ses insrmtlions for compleMq [his lorm on back oi yellow aopy
A46 "X" Below Work Covered by Thrs Request
eaoaoai-os
ype of 8uilding Appliances Wired Equipment Wired
e Range emporary Service
lex Weter Heater Electnc Heating
M Bwlding Der Load Management
m./Industrial Furnace Other (Speciiy)
m ir Condrtioner
r(specAy) Gontractor's Pemarks
Ons
Compute Inspection Fee Below.
# Other Fee # ice Entrance Size Fee k Circuits/Feeders Fee
Swimming Pool 200 Amps 0 to 100 Amps
Transtormers e 200 Amps Above 100-Amps
Slgns Use Only T?TAL
Irrigauon Booms f
Special Inspecuon
AlarmlCommunication THIS INSTALLATION MAY BE OROERED-DiSCONNEQTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
1. the Eleclncal Inspectoc, hereby Ro°9n'" ( oa?e
certify that the a6ove inspection has
6een made. Fca
77 ,
OFFICE USE DNLY '
This requesl vmtl 18 months irom
T8i5 requesl vmd
wmhs4rom O /
? 36947 7/ C? d `7
Request VatO \ Fve No. fldu h-in Insner,t?on
RCq rteA?
eady Now Q WtiI Nou1y Insoec-
L? ?Yes No lor When ReadV
,censed Ele.c[ncal Conlrac[or -_ -- • I hereby repuest inspection oi above
wner elecVieal work installed at.
Sireet Address, Box or ouje Na, ? Citv
%3? l d ?-
ecLnn o. Townshi0 ame or No. flange No. Counry
?"
Oc paAt IWiINT? ^
V Ph ne No.- ?? p)
?U
wer Su pher AAdress
EI ical ontract°r ir^mp
any
Ndmel
o ense No.
Convaclor's
Lic
?
?
- ??
^
O
Mailing AdJress (CO ctor or Owner MakinA Ins[ailauonl
3 2_d
Av r¢etl Signamr Co hactnr/0 er Makiny Installatinn)
sS?3? 8u Numba
?o-3ias
MI"ESOTA STATE BOARD OF ELECTRICITY
Grigge-Midwey Bldg. - floom N•191
1827 Univarsotv Ave.. 51. Paul. MN 56104
Phone16121642-0900
THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BY THE STATE BOAHD
UNLESS PpOPEN INSPECTION FEE IS
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ea-ooaoi-os
, Sae insbuctmns br compleh.g this lorm on Eack ot Vellow copy.
0` 36947 "1(" Be/ow Work Covered by Ihis Request
Add fleD Tvpe oi 0uilamA APpluancns Wiree Eqmpment Wued
Home Range Temporaiy Service
Duplex rvater Heater Liyhtiny Fixtures
Apt. Bwlding Dryei Electni; Heatin
Cominercial Bidy. Furnace Silo Unloader
Indugtnal Bldg. Air Conditioner Bulk MiIk Tank
Farm Otnvr oeci v Jnrr ISpo<:tyl
t er pocify Othcr pihue
l.Ulf1U(/IE IASOCGLfO/IYPF 6BfOW
k Fee ServiceEnlrenceSize p Fee Feeders?Subfeeders M Fee Crtcwts
U to 200 Am s 0 to 30 Am s 0 to 30 !?m o
Above 200 Amps 31 [0 100 Amps 31 to 100 Am s
Swimming Pool Above 100-Amps Above 100 Arnjn
This re4uggt void
16'monthsfrom
0 36950 i , ?Z6,????..??? ?112J
Renuest Oate Fve No. ph-,n InsV.r,1 ion
retl? ?Ready NuwWill Nmdy Inspec-
- - ? Yes ?No or When FeatlY
Lacensetl Electncal Contnctm I hereb re
y ?n
ques? SDaCtion af abovB
Owner electrical work inslalled aC
Street Atldress, Box Rome No.
7 l.?
J'^ir-a-? C?tv
?
ecLOn o. TownsniD Name or No. Range No. Coumy
OccUpa (PeINT) Phone No. ) ,
Power Su0 lier J . Atltlres ?
EI l C nVactor Compa y Namel
ica
?Q,? - I -?-c-?
? Contractor's License No.
03-5l3-S- 3 -7
Ma,lina?.dJress (ConVa r or Owner Makmg Installation) S-?;--3 3 7
Amhonzed Si awre ( onnraclodOwner kin In alla[ion) Phone Number
MINNESOTA STATE BOARD OF ELECTHICITY J, iH15 INSPECTION NEOUEST WILL NOT
GrnAgs•Midwey Bldq. - qoom N-197 V BE ACCEPTE? BY THE STATE BOAFD
1821 Universitv Ave.. St. Paul, MN 55106 UNLE55 PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
R sQU EST uFOR EL ? ECTR ?ICA 9 Ithis NSP ?ECT ?^ON ek o? yellow copy
" ?? j?1ss
Ce? 3 6-95 Q "x" 8e'nw W,, k Covered by Thrs Request
AAd Pao_ Type of 9uilEmg Applmncas Wvatl Equiument Wired
Home Fange Temporary Service
Dupiex Water Heater Liqhtiny Fixtures
Apt. BwIAmg Dryei Electnc Heatin
Commercial BIdG. Furnace Silo Unloader
InAustnal 81Ag. qir Conditioner Bulk Milk Tank
N Fee ServiceEnhenceS¢e tt Fee Faeders/Svbfeetlers K Fex CIr urts
to 200 Am s
0
0 ro 30 Am s
0 to 30 F.m s
? Above 200 qmps 31 to 100 qmps _ 31 to 100 qm y
Swimming Pool Atwve 100_Amps 7 Above 100_Amps
Transtormers IrngaLOn Booms 5?"?D Partial."Other Fee
?•a??? apeuai inspecuon
$
Nertw.ks TOTAL FEE
az ? 117_
.3, ? c?
flough-in 0 DS ?/
•?
e
?
?
the Etectncel
?soecione.eev
Final
? q
?/
?1e
)? carlily thet the above
msoectwn has bean
7'"OW' mada.
This ropuest vo1C