2140 Diffley Rd - Electical Permits?his reque5t void
18 mo Ih 4
Li?.
NPquesI Date
9 re No. Rough--n inspection
? ired? ?Na
Yes
?ReadY Now?Will Nolify Inspec-
Ior When R¢2dY
?1Licensed Elecvical ConVactor I hereby request inspection o/ above
Owner electrical work imiallad et:
Stree[ AOtlress, Box or Houte No. City
2/ O C O vN? i9.t1
ectmn o. I I Township Name o No. Ranqe No. County
AIur.
Occupant (?INT) Phmne No.
• e,?d?Y 0 ooC
Power Supoiier AtlAress
?-
ElecVical ConUactor (COnNaoy Name) Cmlractur s License No.
L C e l{/ CJDU 2
-J? ing Atldress (COnuacwr or Owner Maki'g I taila[ionl
1R?..._ .. L I i./ - . - L I"....1 )0(11.. f.C YINNESOTA STATE BOAND OF ELECTIIICITY
Grigga-Midwav Bldg. - Room N-197
7821 University Ave., SC Paul, MN 55104
Plqne (612) 2972117
i z zi-Yr?i
TNIS INSPECTION RERUEST NILL NOT
BE ACCEPTED BY THE STATE BOARO
UN\ESS PROPER INSPEGTON FEE IS
ENCIUSED.
REQUEST FOR ELECTRICAL INSPECTION ee-aooo,-oe
? See inslrvctions br comp,eling ihis brm on back af yellow copy. ?CE.?L? 042624 *" Below Work Covered by This Request
ew Add 17epj TypeotBuiltling ApDliancesWired EquipmenlWiretl
Home qange Temparary Service
Duplez Wate? Heater Electric HeaNng
Apt. Building ?ryer Load Management
Comm./Industrial Fumace Other (Specify)
? Farm Air Conditioner
Other(syecily) Connecmr5 RemeBS'.
Compute Inspection Fee Below:
vi Other Fee # ServiceEntranceSize Fee Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps to 100 Amps
hansformers l
Above 200 _ Amps P 700 _ Amps
Above,
SignS Inspecror§ Use Only:
Irrigation Booms •
Special Inspection
Alarm/COmmunication $CONNECTED IF NOT
THIS INSTALLATION MAY BE ORDERED DI
Other Fee ,
COMPLETED WITMIN 18 M S. r
I, the Electrical Inspector, hereby Rough-in
Certity that the above inspeCtion ha5
been made. F;nai
OFFICE USE ONLY
This request voitl 16 months Irom
M 07524
REQUEST FOR ELECTRICAL INSPECTION
? See ieshuctions Nr mmplefng ihis lorm on back ol yellow ropy
"JC" Below Work Covered by This Request
E6.00001.08
. ,?Z
ew Acttl- Faq TypeofBuilding AppliancesWiretl EquipmenlWired
Home Range Temporery Service
Duplez Wa[er Heater Eleclric Heating
Apt. Building Dryer Load Mana ement
Comm./Industrial Furnace Other (Specity) -
Farm Air Condifioner
Other(specify) Conlractor5 emarks'
Ex+ 1a.r.w CljoQfAde
Compute Inspection Fee Belaw:
!E Other Fee # ServiceEntranceSize Fee # Circuits/Peeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps /
Transtormers Above 200 _ Amps Above 100 _ Amps
SIgnS Inspactors Use Only: TOTAL
Irrigation Booms
Special Inspection
?
Alarm/Communication ? DI ONNECTED IF NOT
THIS INSTALLATION MAY BE ORD
Other Fee COMPLETED WITHIN 18 MON
I, the Elecirical Inspector, hereby
it Rouyn-in oate
y that the above inspection has
cert
been made. p;nei ?
41
4 Daie ???
.
OFFlCE9SE ONLV ?
This reques[ void 18 months hom
, - 40
V/o ?5 24
1,
Requesl Date e No. ugh-in Inspeclion
Ro
Reqviretl? NOTICE: Vou Mus1Call Electrical Inspector
II A Rough-In Inspeciian
7 ?
Ves ? Na 1s Requiretl.
I;?tlicensed contractor p owner hereby request inspection of above electrical work at: .
Job Address (SVeet or Raute Na.) I Cg 69
e aL
Section No. Tow sh Nam or No. Raige No. Counry
?o fa
Occupan 'PRINTj
14
'r
w Phone No.
e eAv
+er a
i
Power Supplier Atltlress
EI c[ri I ConVactor (Company Name)
? Cont?or5 Llcense No,
oa?13
N?,
M!ailing Htltlress (COnlractor or Ownar akin Installation)
?
?
b7 ? I
T
/ V ? ? ??
ANnorized ' naWre ( on aclo wn aking Inslallation) Phone Number
Li? (-
G 1?.5 =J 7ifl
MINNESOTA STATE BOARD OF ELECTHICRY S
J?
Grigga-Mitlway 61dg. - Room 5-179 w
,
?P
1821 University Ave., St. Paul, MN 55166 (??
e q?
?
hone (612) 642-0800
?? THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BV THE $TATE 60AR0
UNLESS PROPER INSPECTION FEE IS
...?I)
ENCLOSED.
n
? ee-0ooo,///-o??ye
'/?S REQUEST FOR ELECTRICAL INSPECTION 4"
See insimctions for corhpleting inis lorm on be,k oi yellaw copy ? S?/?
M ?')
by This Request 111?,•?
Inl 68968 "X" Below Work Cove' ?1 1
aw AddI Rep. TypeoiBuiltling AppliancesWirad EquipmeniWired
Home Range Temporary Service
Duplex Water Heater Electric Heatinq
Apt. Building Dryer Other (Specify)
CAmm./Industrial ' FUrnace
Farm Air Conditioner
s ) ConVactor§Remarks'.„
X015
% L JLC?c d"?pJ ?
Compute Inspection Fee Below: Orr ?
N Other Fee # Servi EntranceSize Fee N Circuifs/Peetlers Fe
Swimming Pool 0[0 200 Amps ? to 100 Amps
Trensformers Above 200 _ Amps Above 100 - AmDs
$i(jpS Inspecror5 Use Only: TOTAL
l
Irrigation Booms 7 ..\ L
Special tnspection
Alarm/Communication THIS INSTALLATION MAV BE ORDERED DISCON C D 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 , oa?e
1
OFFlCE USE ONLY L"V
This requast voitl 18 months from ,
-L
lI
y/6 9
W968
a ?. °a
,C 1,2 -
? D
Request Date
?' Fire No. ROiMh-
fiequi ? mM1On J
? Raady NowWill Nofily Inspectar
? Yes No When fieatlY?
I El licensed contractor owner hereby request inspection of above electrical work aC
.bb AtlGress (SVeet, Box or Ro e No.) CNy
C
- -3 D ?V
.
$ection Na. iownship Name or No. Range No. Counry
/
Occupanl?PflINT)
C Phone No.
89!?- -73 ?
PowerSup?lierS
? ?
;;; AtlEress
ST
Eiacincal ConV or (GOmpany Name) Cont ctor5 License N0.
dl??
Mailing Atldrass (Contr r or Ow er dking Inst tion? ?
. ?
Authori na rel racorNw akinq s 1 n) Fhone u ber
- 73`1
MINNESbTA STAiE BORRD OCTRIGITY ?V THIS INSPECTION REOUEST WILL NOT
Grlg9s-Mltlway BIEg. - Room 5-173 6E AGCEPTEO BY THE STATE BOARD
1821 Ilniversfty Ave., SL Poul. MN 5510C UNLESS PROPER INSPECTION FEE IS
Plqm (612) 15O2-000 ENCLOSEO.
REQUEST FOR ELECTRICAL INSPECTION
/ ? See insvuctians for complefing ihis brm on back of yellow copy.
R .9 8-4.6 3' "-X° Below Wark Covered by This Request
0 EB-00001-07
C'o?/9gD
a Atld Rep. 7ypeofBUilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Elechic Heating
ApL Building Dryer Other (Specify)
Comm./Industrial Furnace X Fig'e 7.q
Farm ' Air Condftioner
Othar (specity) Comraclor§ Remerks:
G'60 II ?o) G?.P ?.vjc
a
Compute lnspection Fee Below: ?f S?' } ?? 1°°
I .-Sc - a#- 5....rc
# Other
F Fee # ServiceEntranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Ahove 200 _ Amps Above 100 _ Amps
Signs inspedors use onry: 707AL
p
S
Irngation Booms Z+
# f
?
Special inspection O`
Alarm/Communication ?Z So
Other Fee
I, the Electrical Inspecto5 hereby
if
h R°"gn-in
i?
cert
yt
attheaboveinspectionhas
been made. Final
( D.I.
3
OFFICE USE ONLY
r
This requesl vuk 18 months hom
7
Ei 9846\3
dl?
Request Date ?
y`
? Fre Na. floughin Inspectlon
qeGui?,y?
? Ready Now?Will Notity Inspector
R
d
?
Wl
1
- ? Yes o en
ea
y
IXicensed contractor ? owner hereby request inspection of above electrical work at:
Job Atltlress (Sheet, Box or Route No:)
Z11jo L?i?le kd2. Ciry
TE,?'- a--?
Secfion No. Townshi0 Name or No. Rarga No. County
Occupanl(PRINT) G¢ #?'jiLr PhoMNO.
SrFD, sckoaf D.sF-. 4 I41
Power Supplier Atldress
Ek?cIlriK.y' Conlraclar (COFmpeny Name) /
(? Contrec[or5 License No.
IIAI'
611.y? i7:r4
Mailing AtlEress (COMraMOr a Owner Meking InsWlatbn)
yos w. cL.E. r4 SS i
Aullwrized SignaWre (COnUaclw/Owner Makirg Inmllation)
Phone NumOer
Lt 6 3 -?, 6 '3 (
I
MINNESOTA STpIE BOAPU OF ELECTpICRY THIS INSPECTION REOUEST WILL NOT
Griggs-Midway BWg. - poom 5173 eE ACCEPTEO BVTHE STATE BOARD
1821 Unlversity Ave., SL Peul, MN 55101 UNLESS PflOPER INSPECTION FEE IS
Phone (612) 842-0800 ENCLOSED.
^7 J REQUEST FOR ELECTRICAL INSPECTION EB'000?011"04
?s//( // ' See irstruetions tor completirg this form on Imek of yellow, wpy.
B'2_0v?' 2 ""X"' Be;iw WbYk Covered by This Request
AAtl Reo. Tvoe ol Builtlina Aoolianeea Wirad EquiDment MirM
Water
# , Fee ServiceEntrancaSixe M Fee Feeders/Subleeders 4 Fee Circmts
o 30 Am s 0 to 30 Am
pmps 31 to 100 qmps 31 to 100 A
ool
im Above 700-Mi Above 100_E1rt4?+
Irrigation Boorr?s *%Vw Partial-'Oiher Fee
Signs $pecial Inspec!fon SwQ?'O TOTF%?
• Remarks .(
RouOh-in Date
?_ t? Elecviwl
I.pector. hereby
- certifr Ihec [M above
Final ( ? i?rspection Ima besn
de
.
.
Tlq mpuest voW 18 monlls Imm -
116??Ii95 S?o 4Y a
A 42 24 t
Repuesl Date
?_n ?
I?` .. ire No. Ri Inpseclion RequireE
(Yau musl wll ins0ector when reatly) Ins ection ORier Tnan RouBhdn
? qeaEy Now? Will Notity Inapactor
? q ? Yes ?.NO Oale ReaOy
I licensed contrector !7 owner hereby request inspection of above electrical work at:
Job Atltlress (Slreet. or te No.) Ciry
Z? c ?
Setlion No. Township Name or Range No. Coun/
OccupanllP INTJ ? Phone No.
V T
Power Supplier qEtlress
Elednwl Comraclor (COmpany Name, Conlractor§ License No.
T
Meiunq qtltlress ICOnVector or Owner M_ek(ig Installation
?
9 ?' n 5?3?8
r1 r ? oniracto ner Maki g Insteu ion? P?one Number
?
c
MINNE OTA STATE BOAPOOF CTFICITV THIS INSPECTION REOUEST WILL N0T
Griggn-Mitlwey BIEg. - fl ?1)3 BE ACCEPTED BV THE STATE BOARD
1821 Univnaity qve., 5[. ul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Plrone(61Y) 602-0800 ENCLOSED
.
minnesota state aoara oT tiectnctty / 15 p-7=P-
to54 University Ave., St. Paul, Minn. 55104-Phone 645-7703 41111111iii- __
' REQUEST FOR ELECTRICAL INSPECTION P
ECK BELOW WOKK COVERED BY THIS REQUEST
CfI 88619
Type of Building New Add. Rep. Check Apptiances W'ved For Check Equipmen[ Wired Fm
Home ?
Duplex ? ?
? ?
? Range
Water Hea:er ?
? Temporary W'ving
Lighting Pixmces ?
?
ApL Bidg. ?
Commerciai Bldg. ? ?
? ?
? Oryer
Furnace El-/
L7 Electcic Neating
Silo Onloader ?'
?
Industrial Bldg. ?
Farm ? ?
Other ? ?
?
? 0
?-/
?I A'v Conditioner
List
Herefs?
f ?
.??
? . Bulk Milk Tank
List
Hehers?
f ?
CQMPUTE INSPECTION FEE BELOW
Se[vice Enhance Size: # Fee FcedecsBcSub eed ee C'vcuits: # Fee
0 to IDO Am s. 0 to 30 'sk. 0 to 30 Am eres
101 ro 200 Amps. 31 to 100 res 31 to ]00 Am eres
Above 200 Amps. Above 100 ? ps Above 100 Amps.
Tiansformers Remote Control Circ. Pa?tial o: other fee
5i ns $pecial ins ection Minimum fee SS 00
Remarks
µt?.,l
TOTAL F Lf SQ
-e
I, the Electrical Inspector, hereby certify
(Final) _
This request
has been m`aHe.
l-ia-?p
This r*est void'18 montlis from /q /3 49 7?
IC,fRL_j3??C.C?.
Date oF this Request 88619
I, as O-Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at: le? ,
Street Address or Route C
i
ty.
J
Section Township Range /
County
lybich is occupied by
tname o* vccupani,
.Is a roughin inspection required on this job? No e Yes ? Ready Now Will Call ?
Power Supplier Address
Electrical Contractor A?? ??? Contractoi s License o.
(CO?m7p?any Name) -],?? ?
Mailing Address ?Z[? / Ci?+?SS?o/?
(Electrical Contra or or Owner Making T s Installatlon)
Authorized Signature ?:EPhone No. l,2 '.21f'
(Electrl<al C tractor or wne? Making Thls Installatlon)
????? 0????? ???? This inspecvon request will not he accepted by the
State 8oerd unless praper inspection fee is enclosed.
Minnesota State tloard of Electncity
? 7954 University Ave., St. Paul, Minn_ 55y104-Phone 645-7703
'REQt1EST FOR ELECTWICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REQUEST
/ a,?° 7
P 88616
ype oP Building New Add. Rep. Check Appliances Wired Foc Check Equipment W¢ed For
Home ? ? ? Range ? Temporaiy W'ving ?
Duplex ? ? ? WatexHea:ec El LightingFixWces ?a
Apt. Bldg. ? ? ? Dryer /
? Eleciric Heating ?
Commeicial Bldg. ? ? ? Fumace ?
IQ Silo UNoadei ?
lndustrial Bidg. ? ? ? A'v Cond ? Bulk Milk Tank ?
Fazm ? ? ? LIs ,. List
Other
?
?
?e ??, ?
Hehei$
Fce
D to 1D0 Am s, 0 to 30 Am tes 0 to 30 Am eres
]Ol to 200 Amps. 31 to 100 Amperes 3] to ]00 Am eres
Abave 200 Amns. . Above 100 Amns. Above 100_Amos.
Remazks
TOTAL F
I, the Electrical Inspector, hereby certify that the above insp(Qction has been
!D_....L :..1 /f 2 .--p / ( T-
(Final) {/vr
This request void 18 months from
Soc ly
__ ,,.yuest void 18monihs f:om ---- - C(, ti.a--
. ?,?,6 ? c,?. ? ; ,??. °°4 P
.? es ?is7
IYate ?of ty? s Request_ ?.2 8
I, as L8'Licensed Electrical Contractor OOwner, do hereby request inspection of the above electri-
cal winng installed at:
Street Addcess or Route No. .O/y0 c Zy /?W --?, V City-?
$ection Township Range County
Which is occupied by
,,.a, .a .,, ..__...._..., -/
Is a roughin inspection required on this job? No L3"'- Yes ? Ready Now ? Will Call L7
Power Supplier Address
?
Electrical Contractor Contractor's License No.
(^or7any Nama)
Mailing Address
Authorized
or
No.
ST.??? ? 0??? ???? This inspeetion reqPespwill nPt he accepted by the
State Board unless ro er ins ection fee is encloud.
JrREGIUEST FOR ELECTRICAL INSPECTION ?4 ' 3?q4,, C EB-00001-08?
M ? ? S?instmctiore lor completing this torm on Eack of yeliow copg ?F17??9 f?m
wj 8,?,? ?"r' X" Below Work Covered by This Request ?.`?A
e Adtl Rep. TypeofBuiltling AppliancesWiretl EquipmemWired
Home Range Temporary Service
Duplex Water Heater Electric Heating -
ApL Building Dryer Other (Specify)
Comm./Indusirial ' Fumace
Farm Air Condi[ioner ./Ze /j 121.
Other (speti ) ConVactar's Remarks:
Compute Inspection Fee 8elow: T ? ,.e, 4i . efF????
# Other Fee # Service Entrance Size Fee # CircuiulFeeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps ?
Transiormers Above 200 _ Amps ove Amps
SIgnS Inspector9 Use Only: TAL r/1
Irrigation Booms ?4 Dd ?
Special Inspec[ion
Alarm/Communication THIS INSTALLATION MAY B"RDE ?ONNECTED IF NOT
Ofher Fee
aa,
COMPLETED WITHIN 18 ' HS.
I, the Electrical Inspector, hereby
ceAity that the above inspection has
been made. Rough-in
F,nai
60-
OFFICE USE ONLY
Tnis request wk 18 montns from
T/a0/9/
a 6 8 9 3,U 4./?
Request Tat .. , . Fire No. Pough-i0 Inspection
Requiretl?
? Ready Nav ?Will Notity Inspeciw
? 0 Yes NO When Reatly?
I El licensed coniractor Kowner here6y request inspection of above electrical work at:
Job Address SVeet, Boz or qoute No +?! ?"A
<JU/
C
?
/? XI7?'
, e " Ciry
?
l
F
x,
e
$ection No. Township Name or No. Range No. Coun
Occupant(PRINT) Phone No.
C?? % t3?c?/??'?-•e ?'Q?e?L - 311
Power Supplier .
l Atldress
?;-r
? C
Electncal omractor (CO any Name) Convaclor's License No.
Mailing•AOtlress ( nvactor or Owner Makln Instsllstion)
?
, ? ,
Aulhorizetl I lufe ?COnVa ylorlOwner ing In a
r Phone Number
/
i+ . .. . X? . . ?.. ./ ??
MINNESOTA STATE 80Aq0 OF 8l"ECTFIQTY THIS INSPECTION REQUEST WILL NOT
Grlggs-MlEway BIOg. - Room S173 BE ACCEPTED BY TNE STATE BOARD
18P1 Universlty Ave., St Paul, MN 55106 UNLE55 PROPER INSPECTION FEE IS
Fhone(812) 692-0800 ENCLOSEO.
/3/90
P 9421
REQUEST FOR ELECTRICAL INSPECTION
? Seb inslruclions for comp;ating ihis lerm on back of yellow copy.
'X' Below Work Covered by This Request
EBA0001?0]
e Ar'J Rap. - TypeofBuiltling AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Eleciric Heating
Apt. Building Dryer Other (Specify)
Comm./lndustrial Furnace
Farm Air Contlitioner
s e' Coniractor5 Remerks:
Compute Inspection Fee Below:
# Other Fee # ServiceEniranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps o to 700 Amps
Transfortners Above 200 _ Amps A§evo-.ee?r
Signs inspectork Use Onry: TOTAL
Irri9ation eooms
Special Inspection
Alarm/Commupication
er F /?j "
I, the Eledrical Inspector, ereby
' Rough-in Date
ced
rfythatthea6oveinspectionhas
been made. Final oa? .-_ Q'
f ( )
OFFICE USE ONLY ve-A,
Thia request voftl 18 moMhS fmm
? 1.! /qv
? 39421.G?? ` r 1.,;;A
Requasl Date e No.
? 12 Rough-in Inspection
Fequiretl? JJ''
? ReaOy Now ?rvill Notlty Inspeclw
?
4, 0 ?s When Reatly?
x1licensed contractor ? owner hereby request inspection of above electrical work at:
.bb Atltlrew (Street Box or No.) City
Section No. Township Name or No. Range W. Coun
?Tq
Occu RINT) Phane No.
.e
Power Supplier qWd.
Elect " tracior (COmpany Name) Conhaclor§ Lkense No.
L? ? a, 9 yp y
Meililg A ress (Caniraqor or rier Mekieg In I on)
r?"
Au! rizetl SignaW onir r MaWng laticn) Phorre Nu l.,'/?
G/G ?A
MINN A STA7E BOAFiO OF ELE RV . THIS INSPECTION REOUEST WILL NOT
Gdggn-Yitlway Bltlg. - Raom &1 BE ACCEPrED eV THE STATE BOARD
1821 University Ave., SL Poui, MN 66104 UNLESS PROPER INSPELTION FEE IS
Mone (612) 842-060p ENCLOSED.
,_I II I II I I? I? II I I II I I I I ?+ ?I REQUEST FOR ELECTRICAL INSPECTION ?p4?
I Minnesota State Board of Eledricity
1821 University Ave., Rm. S-1,?8, S}.?P?ul, MN 55104
* 0 2 8 8 1 3 4 O*- Phone (612) 642-0800 ?'/? 61
Home Duplen Apt. Bldg. Othe
? ew
N
Addn
Commerciol Indusfriol Farm S Remod Re air
Air Cond. Hfg. Equip. Water Hk. Load Mgmf. Ofher:
D er Ran e Elec. Heat Tem . Service
"k' above fhe w ?k fovered b this reAue? Enr rPmarks in lhis space and on the back of tfie whife copy only.
#ll?/sCe ??.-s e ?
Colculofe Inspection Fee - This Inspection Request will not be vccepted without the correct fee:
Olher Fee # $ervice C-nfronce S¢e Fee # Ciraits/Feeders Fee
Mobile Home Park Sfall 0 to 200 Amps S 0 to 100 Amps
Street Lig./Troffic Sig. Above 200 Amps Above 700 Amps
TransformedGenemtor INSPECTOF'SUSEONLY TO??Jp ?
$ign/Outline Ltg. Xfmr.
Alorm/Remofe Con}rol ,
5wimming Pool o? .?d m? m:mllation descdbed here?n on the daros zia*d
I hercb ro,n n
Irrigdiion Boom ,
Rough-In ?k
ecial Ins
$
ection io
p
p
Investigafive Fee 0
Final Da
THIS INSTALLATION MAY BE ORDEREU DISCONNECTE F N OMPLETED WITHIN 1 8 ON S.
..L V V-13 4DI OFFI?jULi is raquest void IB monihs irom.alidanon daie pnnted tn Ihis bq{„?
or i_ ?. ?r
?o cioc t?
I ?
D 60
k
?
PLEASE PRINT OR TYPE p? IXoQ.M1 ,
(
?
Reqi:est Da Roogh.in Inspetllan requlred2 ? Yes
1?'IJo
u m
h d r? Inspernan Other Than Roogh-In: ? Ready Now $7 Will Call
d ? ?T
D
R
ou must 'o
e ira
ce?m
?vi . w e? rea l
v
ak
ea
r?
I, licensed <ontrodor 0 owner hereby reques} inspection of the nbove eledrical work af:
lob Mdresn iSVee,, Box, or Roufe No) Ci
?O<e?c Zip Code ?
S`s"/?
Secfion No. Township Name or No. Range No. Fire No. Caonry'n
Occ ont Phane No.
Power SovPlie^
P J Mdress
lennml Canwdor Compo y ame? Canhoctur Icenx Na.
f?DDS?L Master Lic. No. (Planf Eled.Only)
G
M ?dras ?COnM1acmr ar PeAorming Installoli ? ?1 ??L/--??]
Au?lhonzed? Si?gnaNrc (?COnhacror or Owner ?.llafion? Phone Na.
EB-06OOIA40 6/95 STATEBORRUCOPY-SEEINSTRUCTIONSONBACKOFYELLOWCOPY
IIIII IIIII II II I I III III I I I ulI II II III REOUEST FOR ELECTRICAL INSPECTION ? LK
Minnesota SWte Board of Electriciry fo
1821 University Ave., Rm. S-1 8, S. PaW, MN 55704 0 2 4 9 2$ 0 2Phone (61?' ' 2-0800 ?0 Y2 terilange uplex Apt. Bldg. Olh dusfrial Farm fg. Equip. Woter H}r. Load Mgmt. Oiher:
Elec. Heat Temp. Service
_W' obove the work mvered by this requesl. EnMr remarks in fhis spoce and on the ba<k of the white copy only.
Calculate Inspecfion Fee - This Inspection Requesf will no} be accepted wi}hout the corretf fee:
Other - Fee # $ervice Enha(xe S¢e Fee # Ciwih/Feeders Fee
Mobile Home Park Stall 0 ro 200 Amps 0 to 100 Amps
$treei Lig./7roffic $ig. Above 200 Amps Above 100 Amps
TronsfortnedGenemtor INSPECTOB'SUSEONLV TOTA?
$ign/Ouiline Lig. Xfmr. ? Ol
Alarm/Remote Control
Swimming Pool -" -
I her nl Ihaf l ins ?w Installation dasaibed herein on the dvres sNled
Irrigation Boom „9h-i„ om?
$peciol Inspecfion
TH
Invesfigafive Fee
IS INSTALLATION MAY
BE OR Firwl
??
DERED D SCONNECTED IF NOT COMPLETED WITHIN 18 MON H5.
?
2 4 9- 250
OFFIC?;O'SE NLY This reqvaf vaid 18 monMs fmm volidmion dale printed in Jnis b? ??t
E `
/4
8
PLEAS
PRINT OR TYPE o
11
Reqowf Dare Roogh-in inspetlion requir dR [] Ves No
14 Inspetlion Other Than RaughIn)9- Reody Now 0 Will Call
( ., '-) ?You m?st mll ?he Inspeclar when ready) Dote Rmdy:
I, licensed conhacior ? owner hereby reques} inspedion of fhe above electrical work af:
Job Mdmss (SVee1, Bov, or 0.o,Ae No.) Gry Zip Code
Secfion No. Township Name or No- Range No. Ftre No- Counry
O <uPon /
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I
S Phane Na.
c4.
ChnO
OK
Power Supplier Pddress
E?Mriml C Imctur (Compoiry Nome) nw
r license No.
M Mmter lic. No. (Plam Elen. Only)
Q V\ LZ /
?
,ry o?G I?
Mailing Mdresz jConhacfor o O+mer PeAormin8lnsioliotlon)
S
s-
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s
??/y
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6 -
1 .
AulhoAUd SignaWre IC PeAorming Irntallafi? Plwne No.
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EB-00001A-10 6/95 STATEBOAIi0C0j+Y.ZAEIN5TRUCTION90NBACKOFYELLOWCOPY
?IM
68965?
REQUEST FOR ELECTRICAL INSPECTION
? Sea inslmctions lor completing Ihis tonn on back ol yellow copy.
Is
"X" Below Work Covered by This Request
?-
?
ew Adtl Rep. Type of Building AppliancesWiretl EquipmentWirad
Home Range Temporary Service
Duplex Water Heater Eledric Heating
Apt. Building Dryer Oiher (Specify)
Comm.llndustrial ' Furnace
Farm Air Conditioner 12 G g
'v Olh (? i ? / Conirector5 RemaBS:
Compute lnspection Fee Below:
# Other Fee # ServiceEntranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Ahove 100 _ Amps
SiJOS Inspector5 Use Only:
TOTAL ?,.
Irrigation Booms O
? I
Special Inspection (
Alarm/Communication THIS INSTALLATION MA Y URDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby pO1gn-'"
? oace
cerlify that the above inspection has
been made. Fm81 oa?e
OFFICE USE ONLY
This rapuest voiG 18 rtronihs Irom
?
,Y/
6 8? 6 5 :, a
Request Date
/ Fire Np. ough-in Inspeclion
Required?
u Ves No ???//{
? ReaGY ?'?'?Will Notity Inapector
W?en Ready?
1 Cl licensed coniractor ?owner hereby request inspection of above electrical work at:
.bb Atltlress Shcel, BOx or PoWe No,) Cily
Seclyn No. TownsniD Name or No. Range o. CouMy
Occupanl(PRINT)
? P?one o.
Power Sup0lier AEtlress
S ??.? sT ST
Electrical Comracto ampany Name) CAnlracta5 Gcens No.
A
Mailing AtltlresS (Lonhactor or Owner king Inslallation)
ao
Autnonze Ignawre (COnvacmr/ n r Making I tionl Phone Number
5 /
MINNESOTA STATE BOARD OF ELECTRICRY THIS INSPECTION REOUEST WILL NOT
Grlyga-Mitlway Bltl9- Room S173 BE AGGEPTED 8Y THE STATE BOARD
1821 UniveMlty Ave., 51. Peul, MN 55100 UNlESS PROPEF INSPECTION FEE I$
PROne(612) 602-0800 ENCLOSED.
?3 REDUEST FOR ELECTRICAL INSPECTION
„ ? See insVUqionn fortompleting ihi5 form on Oack oi yellow copy.
M68951 "X" Below Work Covered by This Request
e ,---
R?Id r
REp. T-
TypeotBuilding
AppliancesWired
EquipmeniWired
Home Range Temporery Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specity)
-
omm./Industrial ' Furnace
F
arm Air Conditioner
?/ OI (sp ) Conhactor§ Reme?ks:
/?
Compufe Inspection Fee Below:
# Olher Fee # ServiceEniran Fee
Swimming Pool 0 to 200 Amps
=
Transbrmers
Above 200 _
s
VW
Signs Inspenwg Vse Ony; Q
Irri9ation Booms
SIns ection
J Alarm ommunication 0
HIS INSTALLATION M?]f?9E O R dISCONNECTED IF NOT
T
Other Fee COMPLETED WRHI g,6 M,ONT
I, the Electrical Inspector, here
by •
Rou9h-in
f
Dete
certify that the above inspection has
been made. F;?y
` ' ei
?
OiFICE USE ONLV
ThiS request voi0 18 monAS Imm
51 .-:5 y '-?5 aaa y
H 6 9 51 `?. ?? 40
fiequest Date ire M. fiougMi? Inspaction
flequiretl?
? Ready N. ?yill NoGly Inspector
? Vas o Nfnen Ready?
I E,licensed coniractor Xowner hereby request inspeclion of above electrical work at: '
Job Atldress (Street or Route No.) City
?
t` /L 1
Section o ownsh p ame or No. Range Na Counry
Occupam (PRINT)
(;-- c Phore No.
- 73//
p0lier
Power Su qtltlress
q
?
Eleclrical Conhact (COmpany Name)
is / CoMrac[or5 License No.
z
Mailing AtldTess (COnVactor or Own Making Ins1aOation) ?
'
?
. l L
Aulhoriz gnaWrB.(GqOnVac1 I)wn/e?/1 aking I
- __ %??' CL?IL// ati9¢)
` -_ ._ Ppone Number `
, 7311
MINNESOTA STATE BOAflD OF ELECTRICITY v ? THIS INSPECTIDN REOUEST WILL NOT
GrlggmMidwey Bidg. - Haom 5-173 BE ACCEPTED BV THE STATE BOARD
1821 Univenlry Aw., 5[. Paul, MN 55101 UNLE55 PROPER INSPECTION FEE IS
Phone(612) 862-0800 ENCLOSED.