3852 Denmark Ave - Electrical Permits18'srrd@y1(e t O V OC%O ^?-'
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Request Date Fire No. Rough-in Inspection
Required?
141 Ready Now[] Will Notify insPeo-
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__ _ myes ?No for When Ready
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I?(ili tensed Electrical Contractor I hereby request inspection of above
? Owner electrical work installed at:
Street Address, Box or Route No. City
emion No. Township Name or o. flange No. County
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Occupant IPRINTI
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Power Supplier
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Electrical Contractor (Company Namel
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Mailing Address (Contractor or Owner Making I tailatmnl
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Authorized Signature (ContractorfOwner Making Installation) Phone Number
X99- a2 9 7!r
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phoo^.!121 642-0800 ENCLOSED.
j/REQUEST FOR ELECTRICAL INSPECTION EeJOOOO/t-os
r? _ , See instructions for completing this form on back of Yellow copy.
LS 7217 "X' Be/ow Work Covered by This Request
p Fee Service Entrance Size H Fee Feeders/Subleaders k Fee Circuits
.610 0 to 200 Am s 0 to 30 Am s 1 12 G.dd 0 to 30 Amps
Above 200 Amps 31 to 100 Amps 00 31 to 100 Amps
Swimming Pool Above 100Amps Above 100-Amps
Transformers Irrigation Booms „s Partial Other Fee
I -L ISigns I I (Special Inspection S/
Remarks I u J sv TOT li .
I, the Elllaaciaar
Inspect.,. hereby
FinalY?P?/ artily that the above
inspection has been
made.
EB-ooool-os
5REQUEST FOR ELECTRICAL INSPECTION JIM.
Sae instructions for completing this form on back of yellow copy.
?'`L i 8 " X- Below Work Covered by This Request
Ada flap. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting FixtmeS
Apt. Building Dryer Electric Heaton
Commercial Bldg. Furnace Silo Onloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm Other pacify ??' Othpr IS pen lyl
t pecily Other Other
ompute Inspection Fee Below _
s Fee Service Entrance Size it Fee FeedersrSubfeeders N Fee cucwts
-
O to 200 Amps Oto 30 Am s /? 3G•?? 0 to 30 Am
or,
Above 200 Amps 31 to 100 Amps OJ 31 to 100 Amps
Swimming Pool Above 100 Amp! Above 100 _Amps
Transtormers Irrigation Booms ,rO Partial. Other Fee
Signs Special Inspection
$
TOT F
L
Remarks ?f ,
I _tn
J?
Hough-in Dcue I
the Electrical
Gd .
Inspector. hereby
certify that the above
Final _ to
a inspection has been
n / ?. made.
This request Vold 10 months from
This request void 1101 F
18 months from O
E -7-2 At 8 1-1o I iL I
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Request Dale
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S' Frte No. Rough-in Inspection
Renwretl?
Reatly Now ? Will Notify bisoec-
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en
eady
Licensed Electrical Contractor 1 hereby request inspection of above
Owner electrical work installed at:
S;reet Address. Box or Route No. City
eclion No. T nsmp Name or No. Range No. County
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Occupant (PRINT) Phone No.
Power Supplier
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Electrical Contractor (Company Name) Cmitraclor s License No.
Mailin Address (Contractor or Owner Making Installation)
?T• rl ?t-G e? 0-1 " `
Authorized Si
IContractor/Owner Making Installation) Phone Number
A47 S'9 9 . ? .2 9,
MINNESOTA STATE BOARD OF ELECTRICITY
Griggs-Midway Bldg. - Room N-191
1821 University Ave.. St. Paul. MN 55104
Phone (612) 642-0800
THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED-