4130 Lexington Ave - Electrical permitsThis request void d`!?' ?a?
18 nwNhs from v d
E 4250?
Renuest Date -? ire N Rough-in Inspetlion
611 Fie?uired? ?Ready Nuw?ll Notify Inspec-
?? ? iRme ? No ?or When Ready
Lfcensed ElecVical Coniractor I heraby repuest inspection of ahove
? Owner electricel work installed at:
Street Address, eox or Route No, CitV
•
ecuon o. Township Name or N. flange No. Coun[y
0LO_
Occupant(PqlNT)
.(3 Phone No.
1-bo16 - S4-55rU
Power Supplier Address
l..[:1
Electrical Cootrac
to
r (Company Namel Co tractor's License No,
I
?
mc( S`F? 1- (-1074 ?6
'Mailing AdJress (Contractor or Owner Makfng Instailation)
) a ytp 9 ?Rncn_t- 4ve- so. ?c( vn n
Authorized S gnature (Con[ractor Owner Making Installation) Phoo f umber
dt Fs96--3?5 55
MINNESOTA STATE BOqqO OF ELECTRICITY THIS INSPECTION HEQUEST WILL NOT
Griggs-Midwey Bldg. aoom N-191 BE ACCEPTED BY THE STpTE 60ARD
1827 Universitv Ave.. St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone16121662-0800 ENCLOSED.
7$f?Fj' REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-os
' See insiructions for comDleting ihis torm on h»ck of yellow copy.
E? 4250 "X" Below Work Covered by 7his Request
AAd flep. Type ol 8uilding Appliancee Wired EquiVmenl Wired
Home Fange Temporary Service
Duplex Water Heater - Lightin,y Fixtures
ApL Building Dryer Electric Heatin
Commercial Bldy. Fumace Silo Unloader
Industrial Bldy. Air Conditioner Bulk Milk Tank
Farm Othxr peci v 01her(suocifv)
ther Vec.fy Other Othp;r
ion fee Below
N Fee Service Entrance Size H Fee Fxnders/Su6leeders t7 Fee Gircuits
0 t0 200 Am s 0 to 30 Am s 0 tn 30 Am s
Above 200 Amps 31 to 100 Ainps 31 to 100 A s
0 . ,.. Swimming Pool Above 100_Amps Above 100_Amps
Trartsiormers Irrigation Boorc?s ? Partial.Ot ee
Signs Special Inspection 5 TOTA
0
Aema rks Q?Q L 6.
Rough-in Dai/a,
Zl
, [he Electrical
. ( . Inspector, heraby
certity that the ahove
Final ? nspect7on has baen
% made.
Tia reauest veid 19 montha Irom
?? , ? REQUEST FOR ELECTRICAL INSPECTlON es-ooooi-os
??
, See instruclions for completing lhis torm on 6BCk of yellow copy.
D' t$ ? 16 "X" Below Work Covered by Ihis Request
L+A'd Hed] " Type ot BuilAing Apptiances Wired EquiUnienl Wired
Home Range Temporary Service
Duplex Water Heater Lightin,y Fixtures
Apt. Building Dryer Electrii: Heatin
Commercial Bldy. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Fafm Olher Peci y OthE?r (SpcrffV)
t er pecify Other plhi;r
(.ompute lnspectlon Fee Belaw
p Fee ServicaEntrance5ize !7 Fee Feeders/5u6feeders Circuits
A U to 200 Amps 0 tn 30 Amns 0 tn 30 Amnc
Poot 1 I I A
to
ReLrks aigns ?,peciai inspection S 99014 TOTAL FK `
?
Rough•in ? [e
?'?
I, the Ele rical
Insvector,
l
f
h
Final /, `'?
/t
/r
_/7?
?I cer
l
y t
at the above
ingpection has been
?.
. I
( mede.
Th1a reQuest vold 18 montha from
i ni5 requesl voltl
18 ?/p/??
months trom 6 l , /?? ? / L' / s, 5;?
Request Date
' Fire- o. Rough-in Inspection
flequfred?
[JReady Now fo Will Nntify, InsDec-
?j -?- ?' oVes ?No tor When Ready
? Licensed Electrical Contractor 1 hereby request inspection of above
? Owner electrical work installed at:
Streec Address, Box or Rovte No. City
/3d /_ E iitl To.u ?i/?NU? ?/f-6-??./
ecUOjl o. Township Name or No. Range No. County
?Kn Ty?
OccuVantIPRINTI Phone No.
?T. B. /E.J CrF? ?o,?/ sYlzuP.' v.? loo? - /D
Power SupDlier Address
/eD 779' /` d?.?f?P/,CJ?rTdJ??
Electrical Contractor (Company Name) Contrar.toi's License No.
4,10f5T 12- f* 7lIZ 3
MailinB AAdress (Contraclor or Owner Making Inslailation)
Authorized Signat re (Contractor Owner Making Ins Ilation) Phone Number
, 3SS5'
MINNESOT STATE BOAflD OF E CTRICITY THIS INSPECTION HEQUEST WILL NOT
Griggs-Midwey Bldg. - Noom N-191 BE ACCEPTED BV THE STqTE BDARD
1827 Univarsitv Ave.. St. Paul, MN 55104 UNLESS PPOPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.