3804 Denmark Ave - Electrical PermitsREQUEST FOR ELECTRICAL INSPECTION . EB-00001-06
?c ' See instructions for completlrg this form on beck of yellow copy.
91,577r D
lti __ 72€ 0 "X" Below Work Covered by This Request
Namw Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighfi ng Fixtures
Apt. Building Dryer Electric Heatuf
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm 01h,!, pertly .that (Speci f,)
t - Specify Other s 01h,,,
Compute Inspection Fee Below - r
M Fee Service Entrance Size h Fee Faeders/Subleeder3 k Fee Circuits
0 to 200 AMPS 0 to 30 AM OS 6` 0 to 30 Awns
Above 200 Amps 31 to 100 Amps S 31 to 100 Am
Swimming Pool Above 100-Amps Above 100-Amps
Transformers Irrigation Booms Partial-Other Fee
Signs Special Inspection $ 50
T
Remarks .S? 5,0 {E0?
3
Rough-in
Final ?/ _
• k4,.^' ?/ D"le
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D?^e !! (
`?' !/tp ) p nre
Ins actor, hareb
Cerllfy th8i the above
inspection hes been
made.
This request Vold la months from I/?V.- --I-- I
This request: oid //e j9'f1' Leh'/- C%?
1R rmnths from 1 U O VYVJO
E 75Q,,0 21.
Request Date
I Fire No. Rug h, r Ins pepioo
Rogwred?
f.Meady Now ? Will Notify Inspec-
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p
/ Yes ? No 11?e for When Ready
Licensed Electrical Contractor I hereby request inspection of above
? Owner electrical work installed at:
Strae ddress. Box or Route No.
o(
k City
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tinjino No. Township Name or No. Range No. Coun
ty
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Occupeot IPRINTI Phone No.
Power Supplier
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j4 Address
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SS 3 o - ;Za 57-W rrrria
Electrical Contractor (Company Name)
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' Contractor's License No.
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Mailing Address (Contractor or Owner Making Ins tailatiam
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Authorized Signature (Contractor/Owner Mak ing Illationl Phone Number
7-z
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N•191 BE ACCEPTED BY THE STATE BOARD
1821 Uniyersity Ave.. St. Paul. MN 66186 UNLESS PROPER INSPECTION FEE IS
Phone 1612) 642-OROO ENCLOSED.
-REQUEST FOR ELECTRICAL INSPECTION . EB-00001-06
/Sea instructions for completing this form on back of yellow coop
7259 'Y' Below Work Covered by This Request
Add Rep. Type of Building Appliances Wired EquiVmenl Wired
Home Range Temporary Service
Duplex Water Heater Liyhtinp Fixtures
Apt. Building Dryer El ectr ii; HeaUn
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm ther peel y Jher IS Pacify)
t ar Suoci y Olhor
r Omer
Compute Inspection Fee Below
s Fee Service Entrance Size M Fee Feoders/Subteeders G Fee Circuits
0 to 200 Am s 0 to 30 Amts 36- 0 to 30 Amps
-
Above 200 amps 31 to 100 Amps 41
to 100 Amps
Swimming Pool Above 100_Amps Above 100_Amps
Transformers - Irrigation Booms Partial Other Fee
Signs Special Inspection s Yd
TOTA
Remarks 3,s L FE1 rd
Rough-in P Date f I, the Electrical
7-1fJ Inspector, hereby
certify that the above
Final to inspection has been
i,7? made.
r
This reauest void 18 months from
This request void
IS ownths from //S
E1 7259 / a! I?5a
Request ate= .. ire No. Rough-in Inspection
y/ / `, oac Re,)4tyes d? 'Ready Now ? Will Nolity, InsPec-
' -/ 7- p ' IIE*e nNO for When n Ready
Licensed Electrical Contractor I hereby request inspection of above
? Owner electrical work installed at:
Street Address, Box or Route No. // City
-3F? C) PFM
ecuon o. Township Name or No. Tripe No. County
Occupant IPRINTI 1^^1VV
0 Phone No.
E
-r"
Power Supplier s
Address
?L``--Y'4 ik, ` / { i c FowH i,tir
Electrical Contractor (Company Name) Contractors License No.
lbio,& k(!;_ EI?E? ?4
Mailing Address (Contractor or Owner Making Installation)
?tii i < 1 S 3 (>
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id
Signature IGOgtraClpr caner Making Installation)
o Phone Number
JX
6
d
01 1 F7-Z474,7
MINNESOTA STATE BOARD Of ELECTRICITY THIS INSPECTION REQUEST WILL NOT
MNESMidway Bldo. -Room N-101 BE ACCEPTED BY THE STATE BOARD
1821 Univers ilv Ave.. St. Paul, MN 551 g4 UNLESS PROPER INSPECTION FEE IS
Phone(612)642-0800 ENCLOSED.