3920 Danbury Tr - Electrical Permits3 .1i e0 1'29V9
? 4 3 4 6 5
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.
Fequesl Date / fiR No
?1
%2 -f ough' InspecLOn
? ReaE
RYp Notih, Ins
ector
Now
Q ? m
No y
V
p
When Fl
I` licensed contractor 54wner hereby request inspection of above electncal work at:
Job Addres/s ??31ree1 eox oute No ? Giry
?7e2C0 V // .
Secuon No Townsbip Name or No Range No Gounty
Occuaam IoqINTi
?-
? Phone N.
on e
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,
Power Suppiier Atltlress
Elecmcal C udClor ICompany Name) ConnactOr's License No
Onw Wn?
Maiiing atlcr 55 ( ontractoe or Owner Nakmg Insiallaiion)
006,
A,nonzeo aN pnVachor aTer Ma'emg Installation, pM1O ber
MINNE50 STATE 90ARD 0 ELECTPICITV THIS INSPECTION FEQUEST WIIL NOT
Gnggs-MlOway Bltlg. - floom S173 BE AGCEPTED BV THE STATE BOARO
1821 Ilnrversity Ave.. St Paul. MN 55104 UNLE55 PFOPFR INSPECTION FEE IS,
Phone 1611) 642-0800 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION nn ee?-oaooi-oe I
? See msimcuons lor comoleling Ihs torm on back of yellow ropY ?
"_ /•1???r/9
? . 1.
4?4-E j9 "X" Below Work Covered by This Request
ewI Adtl Rep Typeof8mldmg AppliancesWrted Equipmen?Wved
Home Range Temporary Servme
? Duplex Water Heater Electric Heating
Apt Bwldmg Dryer Other (Speafy)
I Comm/Industnal Fumace
Farm Air CondiLOner
Other?syecJyi
I Compute Inspechon Fee Below: Contraclor's Remar
?Srnl. L
"
? i Other Fee # Service Enirance Srze Fee # Qrcutls/Feetlers Fee
ISwimming Pool 0 to 200 Amps 0 to 100 Amps
i Transformers Above 200 _ Amps Above 100 _ Amps
[Signs inspec:ors use onry TOTAL f"D
Irriga6on Booms d,v
Speaal Inspechon
Alarm/Communica6on THIS INSTALLATION MAY BE ORD ED D NNECTED IF NOT
F0ther Fee COMPLETED WITHIN 18 M S. r
I, the Electrical Inspectoc hereby
certrfy that ihe above mspection has
been made. Rou9n-in
F,,,ai
? y
y -
OFFICE USE ONLY
'TFis reqaesl wi0 18 monNS Irom
Th, requestvoid
18 nwnthr Irom
E 1404F;
9OC)33
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Re?°j s!??`/ Fire No. RRequ oup u > InsVer.tion
re /
oReatly Now OWill Nntrty Inspec-
?
Z ?? s ?NO tor When Ready
LJ L,censed Elec[ncal Contractor I hereby repuest ms0eebon ol abova
? Owner eleclrical wmk installwd wc
Street Address eoe or floute No.
?,? ?(1"QiI
a
e
.. "
,ownsnip
Name r No. Range N o. unt
Co
y
?
/
?
I?•I,?IVI tal
OccupantlPplNTI
E (kw tcoee E . mu5k)&Q,n Phone No.
Power Supulier '
OU.1(-4rLL AAd.ess
Eleclncal Convactor (COmOany Name) Convarlot's License No.
Maihng AdJress IConvaclor or Owner Makinp Instailauonl
? ti O SS1Z3
Auffio ize Sienalur ?COmr ior1Owner king InstallaUnn) Phane Nomber
D
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MINNESOTA STATE BOAXD OF ELECTqICITY
Griggs-M.tlwey Blde. - Aoom N-191
1921 Universitv Ave.. St. Paul. MN 55104
Phone 16121 642-0800
THIS INSPECTION flEQUEST WILL NOT
BE ACCEPTED 8Y THE STATE BOANO
l1NLES5 PROPER INSPECTION FEE 1S
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ee-ooooi.os
, See mslrvctions lor completvg this form on bnck of yellow copy 9co?3 3
14 0 4 6 "x eeloW Work Covered by This Request / _? -3c)__ FY)
Hdd flep. Type o1 8uileinq Appbances Wirod Equiument Wue•1
Home Range Temporary Service
Dupk;x Water Heater Liyhhny Fizhues
Apt Bwldinq Dryer Electnc Heatin
Gommercial 81dg Fumace Silo Unloader
Industnal 81dg Air Conditioner Btdk Milk Tenk
Farm O?ner orF-,v .ihFrlspc-rvi
1nn1 ucu v tner Otnc,
LOIIIOI/IB lnSOldCIlO/1 FaP Ha!/,w
N Fea ServiceENrence5iie b Fae Feetle,s/Subfeeders < Fre Circmns
U to 200 qm ps 0 to 30 Am s 0 tn 30 Am s
Above 200 qmps 31 to 100 qmps 31 to 100 qm 5
Swimming Pool Above 100-Amps Above 100_Amps
Transrormers IrrigaLOn Booms Perbai Oth
Signs Special Inspection S L?
S ?7
Rertw.ks
?Q 0TAL F G
-
Nooeh-in ?
`'?,
Final Date
On?e ?
E leclnca I
l tha
?vy t the above
cnspection has Eaen
roiareQuest raioiamommnom V?P WS
?Th.s request voia
18 nwnths Irom ?L =X O
DD 9 8 54.3ii
i'QD' "
S y?'SC?? ?
Ren,,est Date
f ?
I ire No. Rouph? I sper.tion
fle wr0d? ?
Readv Nuw?Will Nntrty Insuec-
?
???
'Q b ?Yes ?NO tor When NeatlV
ucensetl He.c"ncal ConVactor 1 hereby request mspeeLOn ol above
Owner eiectrical work installed at:
Str¢ec Adtlress, eox or ute No. CitY
0
ecUOn o. Township ame or No. Range No. ? ?py
OccuV tIPRINTI Phune No.
' Sa -6? Z
Ptrwer up0her Adtlress
Elecvical oQ actor ICo y Namel Con rzctor's Lir.ense No.
MaiM1ng Ac1Jr ss (Contraciar or wner Makmq Installabonl
.QUthonz nature 1 nvac or/Owner Makiny Installationl Pho Nomb
r
_ ?
? '
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M1+inr+t50PA STATE BOAflD OF ELEC(fpICITY
GrigBS-MIEway Bldg. - Room N•191 «
1821 Univers?tv Ave., St. Peul, MN ?5104
Phone (612) 642-0800
ims IrvSPECTION NEQUEST WILL NOT
BE ACCEPTEO BY THE $TATE BOARD
UNLESS PXOPEH INSPECTION FEE IS
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ea-oooai-os
p ? See instructiom tor complebnp this lorm on back o1 vellow coCV.
? 88543 "X"' Be/ow Work Covered bv This Reouest
Fdci Rep. Typa oi Bmldmq Appluances Wved Equ,pment Wved
Home flange Temporary Service
Duplex
Apt. BwlAinq Water Heater
Dryer Lightmy Fixtures
Elec(n? Neatin
Commercial Bldy. Fumace Silo Unloader
Industnal Bldg. Air Condrtioner Bidk Milk Tnnk
Farm Omr. oe•r.irv .ini" ?su?c,tyl
....
......
., 1..., t ¢r ucu(v
.,,, ,... _ _ r . _ .. , Other pth?r
N Fee ServicaEnfrenceSize b Fee Feeders/Subieeders b Fee Cvcwts
.? U to 200 qm s
Above 200 Amps 0 to 30 qm s
31 to 1 DO Amps 6 0 0 tn 30 qm ?s
31 m 100 q y
Swimming Pool Above 100_Am)s Above 100_Amos
Transformers Irrigation Booms d Parnal 0
Signs $peciallnsPecbon
aemarks $ ? b TOTA FE?3? A
Hough-in V v
the aclri
• Inspecto , ero6y
Final cerUly that the abpve
p, '/? inspecLOn hes been
C?
?n:..?....e.?.....w m.......r.....? made.