3795 Denmark Ave - Electrical PermitsST FOR ELECTRICAL INSPECTION a 4I Ea-cW01-0e(
p ? T. instructions for completing this form on back of yellow copy
9875 X"Be/ow Work Covered by This Request
New id e r, Type of Building Appliances Wired EquipmentWiretl
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other-(Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other lspeciiyl Contractor!b prime
Compute Inspection Fee Below:OOI71 n '
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 010 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Alcove 100 _ Amps
Signs Inspectors use only: TOTAL _ zrl?
Irrigation Booms ?+.jf//7
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in ` Date ?
certify that the above inspection has
been made.
Final -N { veto G
OFFICE USE ONLY i ?:...-
This request void to months from
l5
2"
dI sa
J
- /
d
I
l '
Ra ueal Late
// / rj /1? Fire No Rough-in I pection
Raq Intl?
? Ready Now Will X R
h
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?
en
ea
y
I ? licensed contractor owner hereby request inspection of above electrical work at:
Job Address (Street. ox pr Route 1 City
3 7 5 24MCIL ? Je -
Section No, Township Name or No, Range No. County
Occupant ,PRINT(
k. Phone No.
0 0
V,
Power Supplier Addr.-
Eleclncal Contr tort Compary Name, Contracul License No.
O F0WLisf
Mailing A tlres IDonhaclor or Owner Making Installation,
0J
Aulnoloa
Signa ICpmr
r/Owne king Inslall On, 1 Phone Number
:
7 1715 2- "D2-`I
MINNESOTA STATE BOARD OF ELEOTAIll r THIS INSPECTION REQUEST WILL NOT
Grigge,Midway Bldg. - Room S•173 BE ACCEPTED BY THE STATE BOARD
1841 University Ave.. St. Paul. MN 55104 Qp'IL-y1 UNLESS PROPER INSPECTION FEE IS
Phone (613) 642-0800 T""` ENCLOSED,
18 This
mont ld
hs from
A 089482 Qil r)t
Request Date
!
1 Fira No. Rough-in Inspection
Regm red?
[]Ready Now Will Notify, Inspeo
- 1
®yes ?No
for When Ready
u Lf6ensed Electrical Contractor 1 hereby request inspection of above
? Owner electrical work installed at:
Street Address, Box or Route No. City
3795 DENMARK AVE. EAGAN
action NO. Township Name or No. Range No. County
DAKOTA
Occupant (PRINT) Phone No.
LEIBFRIED CONSTRUCTION (HOPKINS) 463-2122
Power Supplier Address
DAKOTA ELECTRIC FARMINGTON
Electrical Contractor (Company Name) Contractor's License No.
LAKEVILLE ELECTRIC, INC. A041802-9
Mailing Address (Contractor or Owner Making Installation)
20 0 JACQUARD AVE.W P.O.BOX 428, LAKEVILLE,MN.55044
Autho ze Signature (Contra r O
7 Making Installation) Phone Number
49 469-4939
MINN?yOTA STATE BOARD OF ELECTRI TV THIS INSPECTION REQUEST WILL NOT
Grlg MidweY 91tlg• -Room N-191 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 66104 UNLESS PROPER INSPECTION FEE IS
Phone (812) 297.2111 ENCLOSED.
1 REQUEST FOR ELECTRICAL INSPECTION EB-00001-04
e Instructions for completing this form on back of yellow copy.
A 0894h "X" Below Work Covered by This Request yl
Nw4 Addj Rep: Type of Building Appliances Wired Equipment Wired
X Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heating
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Butk Milk Tank
Farm ter (Specify) Other (Specify)
t er ueu y ter Other
Compute Inspection Fee Below
p Fee Service Entrance Size k Fee Feeders/Subfeeders N Fee Circuits
0 to 200 AMPS 0 to 30 AMPS 0 to 30 Am
Above 200 MA 31 to 100 Amps 31 to 100 A E2jLS
Swimming Pool Above 100_Am s Above 700-AMPS
Transformers Irrigation Booms Partia l.'Other Fee
Sign Special Inspection
$
TOTA
emsrks 3 0. 5 0 2A )
w
Rough-in '0
1, he Electrical
hereby
j bove
tha
certt the a
Final Da
tl
} c[ napection has been
?
W made.
This request void 18 months from
REQUEST FOR ELECTRICAL INSPECTION ER-eaom-w
See instructions for cum leti
pc ' p np this farm on back of yellow copy.
B 3 Q 3 O'`Y "X" 8e low Work Covered by This Request o
Add Rap. Type of Ruildiha Appliances Wired Equipment Wired
Horne Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heating
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
farm Other (Specify)
Other (Srmcifvl
t r $pecifY Other Other
Compute Inspection Fee Below
a Fee Service Entrance Size N Fee Feeders YSubfeeders a Fee Circuits
0lo 200 Amps 0to 30 Amos 0to 30 Arnins
Above 200 Amps 31 to 100 Amps 31 to 100 A
Swimming Pool Above 100-Amps Above 100_A
Transformers Irrigation Booms Q Part is VO r6ee
1 I Signs I I Special Inspection ' % "
TOT FEE tiC
rprrarks ? o
i
Ibuph-in are 1, th Elecvi
Inspect - reby
certiry that the above
Final a e / r. r8pecti rm has been
y ? rede.
ttia taquest void 1S months hum
This request void L1j3 (tia & (W
months-NOna• l
smiRs L 3)8 a),
Request Date Fire No. Rough-in !"'pecti'n
4 / ? ` [J'J Regwred? is$ Ready Now ? Will Notify Inseec-
1 (? fp ?yes No for When Ready
Licensed Electrical Contractor I hereby request inspection of above
? Owner electrical work installed at:
StreeljAddree... or /Route No.
7116 City
Section o_ Township Name or No. Range No. CounW (?/yam
Occuµmt IPRINTI 1
?
a Phone No.
z-any (ir
?
a
Power Supp}?H ?
s[' 8 yip. Address
ss Y?c- Tsp.{
Elecn, "tract (Company Nance) r Contractors License No.
Mailing Ads IContractor OwMaking Instaj latum) ?/ J
Ps. JA3 47 /..f.+./??-/yam ,r ?///r
Auth Si azure (Con[r r Qwn Making Installation)
? ? Phone Number
/.-3 Z
MINNESOTA STp BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midwov Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55194 UNLESS PROPER INSPECTION FEE4S
Phone (8121 297.2111 ENCLOSED.'