3864 Denmark Ave - Electrical PermitsREQUEST FOR ELECTRICAL INSPECTION
If See instructions for completing this form on back of yellow copy.
-"k"-Be o or o eyed by This Request
ES-00001-04
37g3C?
Add Rep. Type of Building Appliances Wired Equipment Wired
Home 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 of « fy Iher Isperdfyl
t er Sceci y 0t 01har
Compute Inspection Fee Below
M Fee Service Entrance Size q Fee Fenders/Subfeeders V Fee Circuits
J,9 591 0 to 200 qm is 0 to 30 Amps '? - 0 to 30 Amps
Above 200 Amps 31 to 100 Amps 31 to 100 Am
Swimming Pool Above 100 Amps Above 100_Amjs
Transformers Irrigation Booms ? A Partial/Other Fee
Signs Special Inspection ?0 s '
Remarks Tjd
( ,Et
1' l
cal
M-? I pectoq heroby
cart fly Chet the above
?t 'r9gPection has been
This request void 7-Z
18 months from
W 090359
LIt ( 5/I Lo(-tiA-Cres-?- ! e 37t/3 d
U7,so
Rativ^bsC Da tit, _
Z?
7- Fire No. Roue h-in Inspection
R q fired?
R
w,r??.1(
?Ready No Will Notifv. Inspee
' fo
Wh
R
- yes El No r
en
/
eady
A Licensed Electrical Contractor I hereby request inspection of above
Owner electrical work installed at:
Street Address. Box or Route No. Ci
Section No. Township Name or No. Range No. County
Occupa t (PRINT)
A Phone No.
Power Supplier
CJCXIC% ' Address
Electrical Contractor (CO any Name) Conirac tor's License No.
Mailing A ass IContracior or Owner Making Installation)
Authorized Signature Owner Making Installation)
P1 t\:.A -11) Phone Number
(0, ?6 -A
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griegs•Midway Bldg. - Room N•191 BE ACCEPTED By THE STATE BOARD
??7921 University Ave., St. Paul, MN 55180 UNLESS PROPER INSPECTION FEE IS
\.. ?wro? vow at?• ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
ppi?pp ?((?,,JJ?? 3?' So. instructions for completing this form on back of yellow copy. 11
"X B?o@Wor7 Covered by This Request
EB-00001.04
37q !> O
Adtl Rep. Type of Building Appliances Wired Equipment Wired
Home 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 O p y they l5ueci fy)
t er Sp.c,tV "Ic t - Othui
Compute Inspection Fee Below f '
N Fee Service Entrance Size H Fee Feaders/Subfeeders a Fee Circuits
0 to 200 Amps 0 to 30 AMPS 0 to 30 Amps
Above 200 Amlu 31 to 100 Amps 31 to 100 Am
Swinanin Pool Above 100 Amps Above 100_Anus
TransiormerS Irrigation Booms C;Zfl Partial,"Other Fee
Signs Special Inspection ip T
Remarks FE,I^
r i^
Roush-in Ml' ec for. hereby
ify that he above
Final ' action has been
e.
This request void 18 months from
This request void
'?z. Ip x?
18 months from
W090358
LIA? 5 Ij W A dcres-- /ft 37L136
r s?
q-7
Request Date
r Fire No. Rough-in Inspection
Required?
QReady Now E] Will Notify Inspec-
?yes ?No for When Ready
? Licensed Electrical Contractor I hereby request inspection of above
? Owner electrical work installed at:
Street Address, Box or Route No. City
APDD C<
Section No. Township Name Range No. County
? )
Ocdupan (PRINT) Phone No. /
`
- b
NS
4
9s?
Poy?y
1psupp
lier Address
J
y
E lncal Contractor (Company Name) Contractors License No.
?l
Mailing ddress (Cons ctor or Owner Making Instail ti on)
Authorized Signatur Contractor/Owner aking Installation) Number
Phonne
,,
q
6(22 67 ? /p J
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
P1,- Iatpl gq%gttt ENCLOSED.