3015 Denmark Ave - Electrical Permitsi! . y.
r/7 F' OFFlCE USE ONLY This re es void 18 months I mli tlhon date pnnted m bo.
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' PLEASE PRINT OR TYPE
aousb??, m.pecnon eq.reaz vo,
? N. Inspection (Dther ihvn Roughln ? Reody No WilI Call
fYou must coll the mspecia when reodyj D.I. Beady A K g/ ? o ,J /' /y
I, icensed <ontmcror ? owner hereby r=ques} inspection of fh ove elechical work ot C6
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Fowe?r ?S ppliar ? Address
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Eleclrical Conrcocror (Compony Nome) Conhanor Lcenm No
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Nwilirg Address rConhacror or Owner Pedorming Inslollahon) l?
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REQUEST FOR ELECTRICAL INSPECTION / `5S
4? 0- 4 6 5 ti4innesota. State Board of Electricity
1827 U(612) ivesiry Ave., Rm. 5-728, SL Paul, MN 55104
Phone 642-0800
PHome " Duplex ? Ap;. 81d Ofher New
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1 Addn
C": roercial Industrial Form Remod Re oir
Air Cond Hig. Equip Woler Hh. Load Ivlqmt. Ofher.
Dryer Range Elec. Heal Temp. Service
"X" obove the work covered by th?i request Enter temarks in rhis spoce and an tfie back of the whife opy only.
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Cakulate Inspecfion Fee - iha Inspection Requesf will nof be accepfed wjihovf /he correcf fee.?
Other Fee # Service Entrence Size Fee q Circuits/Feeders Fee
Mobile Home Park Stall 0 10 200 Amps b 7v 0 to 100 Amps Oc,
Sheel Ug./Troffic Sig Above 200dG.?.Am s 1??C? Above 100_Amps
Transformer/Generofor INSPECTOH'S USE ONLY
,?yl G..?.Y TOTAL
Sign/Ouiline Ltg. X{mr. ?
?.50
Alarm/Remofe Conhol 9^"-°?'+•et57A.?.-
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Swimming Poo) /?pq
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I hereb ccii ihm I im ecled ihe x$ical i Ilmde?d herevn on Poe dotes smMd
Irri9ofion BOOm Roughln
Speciol Inspection
Imestigative Fee Finol Dare
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 78 MONTHS.
OFFICE USE ONLY TM1t? r quen'b18 monthrirom vplidanon dare pr'n?-d5/
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Reqoest Date Raui mspection reqmredi ? yes Inspecrion Oiher Than RougMn Reody Now ? Will Call
Cn - (( -i 7 (Yoo must mll ihe inspecmr when ready) ' Doie Ready
I, licensed contmctor ? owner hereby request inspecfion of Ihe above elechical work at:
Job Address (Svcet, Bo., or R.W. Na ) Ciry
F- Zip Code
Saclmn No Township Name or No Range No Fre No Counry
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PowerSugplier Address
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Elecmml Contwcbr (Company Name) Cnnrcatlor N. Masrer m N. IPlam Elxt Only)
Mailmg Address IC.^rc«ror or Owerer Performing Insmllomm) _ i--
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Ea00001 MI 1 8/96 5N TE BOARD COPV - SEE INSiRUC7IOMS ON BACK OF YELLOW COPY
REQUEST FOR ELECTRICAL INSPECTION
4 V(((??? U° 4S4? M821eUniv rslary ABe,rRm. Se 28, St. Paul. MN 55104
Phone (612) 642-0800
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Commercial Indusrtial Farm Remo r
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Air Cond Equip Water Htr Load Mgmt
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Dryer Range ce
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Elec. Heat Temp.
"X" above fhe work cavered 6y fhis request ENer remarks in this space and on the 6ack oF the whiM copy only.
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Calculate Inspection Fee - This Inspecfion Request will not be accepted wifhout the correct fee.
Other Fee # Service Entrance Size Fee N Circuifs/Feeders Fce
Mobile Home Park $tall 0 ta 200 Amps .?U 0 fo 100 Amps
Stree} Lfg./TraHic Sig. Above 200_Am s ave 1 Amps
Transformer/Generator INSPECTOH'S USE ONLY TO
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Sign/Outline Ltg. X
Alarm/Remote CoNrol
Swimmin9 Pool I hemb cen? ?hot I ?nx le tiuwllanon de,ribed herem on the deies smred
Irriyotian Boom RoogMn ? Dote
Special Inspedion F poy?
Inveshgative Fee . ?G ?
r.i u? wv nc n nnFRFn f]ISC[)NNECTED 1 PLETED WITHIN 8 M NTHS.
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