3691 Denmark Ave - Electrical PermitsL54953 i. ??..?,,? his
Request Defe
l Q .y
"L/' Fire No. Rough-in Inspection
Requiretl?
-
edy Now G Will Natty Inspector
Wh
R
d
?
a =; Yes
o en
ea
y
I licensed contractor ] owner hereby request inspection of above electrical work at:
Job Addres
ss (Street. Box or Route No ) City
ss
44,,fl 1w
e
' :? r?
Section No. Tawnshlp Name or No. Range No. County
Occupant(PRINT) Phone No.
; ? Q
Power Supplier !7! A
Electrical Contractor (Company Namel
L'
r-- « Contractor's License No,
.
UG C /.,fiC
l, O
Mailing Address IC. ctor or Owner Making Installation(
G2 rG r ss?
Aul it Signature IC, trac Owner Making (nstallabon) Phone Number
MINNESOTA STATE BVBRD OF ELECTRICITW v f
Griggs-Midway Bldg. - Room 8-173
1821 University Ave.. St. Paul. MN 55100
Phone (612) 642-0800 P
77 go
d 54953
THIS INSPECTION REOUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
? See instructions for completing this form on back of yellow copy.
"X" Below Work Covered by This Request
e Add}gep. " Typeof Building Appliances Wiretl EquipmenlWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) Contractors Remarks:
Compute Inspection Fee Below: G,???/?/?/¢'? -'/?
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 t1 200 Amps o to 100 Amps
Transformers Above 200 _ Amps Above 100 -Amps
Signs Inspe ctor's Use Only -" TOTAL
Irri
ation B
g
ooms S
S
e
i
l I I
O
p
c
a
nspection
Alarm/Communication THIS INSTALLATION MAY BE OR
Other Fee D DISCONNECTED IF NOT
COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in Date
certify that the above inspection has
Final
been made. If oat.
l
OFFICE USE ONLY e
This request void 18 months from
J
Thi<raquesl void 7// l L' I D l t (l ?F.r ??. ??C 30,75T -
?8 months from
8 65 ?? 06
Request Dato Fpe No. Rautlh-in Inspection
Req? red? gady Nnw ? W'ill NoGty_ Inspac-
?^? Q ?yes No for When Ready
Licensed Electrical Cotinacu+r I hereby request inspect'no of above
? Owner electrical work installed at:
Street Address, Box c out" No. p't Ci
S
er.uon No. Tnwn ip Nvrne or No. Rangy No. County
Oc p t (PRINT)
b Phoi t No.
6 lz_?- 0 M -
Power Supplier
'IN Address
El .tr cal Contrast., IGoi ny Nani /y ConI actors Licnnsa No.
a'ili Address (COntL?t r or Owi Making In ailati
Authorized Signa ure (Contractor/O 'Iki 'tallatlmil Phone
ar
, mb
,
R a
-
J
MINNESOTA STATE BOARD OF ELECTRICITY
Griggs-Midway Bldg. - Room N-191
1821 University Ave., St. Paul, MN 55104
Phone 16121 29].2111
THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
'1,l REQUEST FOR ELECTRICAL INSPECTION EB-00001-03
8,?G rr See instructions for completing this form on back of yellow cnpy. O ?i
below work'Covered by This Request 30 1 S 0
New Add Rep. Type of Building APPI...... Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heating
Commercial Bldg. Furnace Silo Uoloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm other Specify other ISpeclfyl
iher (Specify Other Othni
(.OtnoorB N).SOPCrion FPP HPIRW
P e size d Fee Feeders/Subf.ed. rs # Frt. Circuits
Art U to 30 AnIs 0 to 30 Ant s
ps 31 to 100 Amps 31 to 100 Ant s
=Ahove
Amps Above I00 Arnps Above 100_Amps
Remote Control Cite. Partial/Other Fee
Special Inspection S
TOTAL E
R.Ina rks
l.. .. n. n A ma
9ouglrvln Datn I, the Electrical
Inspector, hereby
certify that the above
Final Data Ins pec[i.n has been
This mque5l void
r
d v?-
'
'
7 k
UV 0 8 _ 0 ?4 n T
3
(1(10 O
69
R
Repue<_I Dete
Fire No. Rough-In ease lion Repuire0
(You must call inspector when rea0yl
Inspectipn Other Thlavn.Rough-In
? Ready Now ts( Will Notify Inspector
dW Yes ? N. Date Ready
I eicensed contractor O owner hereby request inspection of above electrical work at:
Job Address (Street Box or Route Np.l City
Section No. Township Name or No. Range No. County
Occupant lPRINTI
C Ncas c:ac.®?,?r,??
cc
Phone No.
Power Suppler Address
EIecVl Conlraclor (Compeny Name)
.vE•?, ? E? CpnVactor9 License No.
CA ll 7?'
Mailing Address (Contractor or Owner Making Inslellatlonl
[?
3 f/ ?
e ??yj
coc
t
?.
Tdt.O L W 4,
, E; S.SS? Z f
Autnonieo Signature IContra[IOnOwner M?stall>)
r? Phone Number
_ 7S/ -
or?67
C oVRHUOr ELECTRICITY
Griggs-Midway Bldg. - Room S-173
1821 University Ave.. SL Paul. MN 55100
Phone (612) 662-0800
THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
5 y REQUEST FOR ELECTRICAL INSPECTION
? See "sImctions for completing this torn on back at yellow cop, r ES-0000108
C? 0 0 810»_
"X" Below Work Covered by This Request , .
VI -FA- ? V lral Isuealyl
Inspection Fee Below:
Other Fee
[ling pool
Other Be Fr-
I, the Electrical Inspector, hereby
certify that the above inspection has
been made.
IFFICE USE DNLy
his request void 18 Tarim, Idea
lAir Conditioner
Contractor's Remarks'.
IwEzt
y.
THIS INSTALLATION MAY BE
COMPLETED WITHIN 18 MOB
Fee # Circuits/Feeders -F-ea
0 to 100 Amps '"p p
Above 100 _ Amps
70TgL
IF NOT