670 Diffley Rd - Electrical PermitsK 9 68 — g
R u st Date
+ 2
- - - -�
q
Fire N.
e o
Roug Inspection
oug sped on
Req fired?
Yes ❑ No
D Ready Nowili Notify Inspector
When Ready?
I licensed contractor
D owner hereby request inspection of above electrical work at:
Job Address (Street. Box or Eloute No.)
(o"? O 1) t .- l RO c-t
City
E& ctv
Section No.
Township Name or No
Range No.
Cou
0. kofict.
Occy�i (PRINT
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Ph CJ
Pow Supplier
Address
Electrical Contractor (Company Name)
C. We; C t La'ric- . iv. .
Contractor's License No.
t3_3
Mailing Address (Contractor or Owner Making Installation)
3 wit\ee„\ock- QE , St e l
Author Signature (Cont to /Owner Making Installation)
Phone Numb
MINNESOTA STATE BOARD OF ELECTRICITY
Griggs- Midway Bldg. — Room S -173
1821 University Ave., St. Paula MN 55104
Phone (612) 642-0800
THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED
Nev
Add
Type of Building
Appliances Wired
EquipmentWired
Home
Range
Temporary Service
Duplex
Water Heater
Electric Heating
Apt. Building
Dryer
Other- (Specify)
X
Comm. /Industrial
Furnace
Farm
Air Conditioner
Other (specify)
Cont actor Remarks:
`��v r d O
Compute Inspection Fee Below:
#
Other
Fee
#
Service Entrance Size
Fee
#
Circuits /Feeders
Fee
Swimming Pool
0 to 200 Amps
0 to 100 Amps,
Transformers
Above 200 Amps
Above 100 Amps
Signs
I nspectors Use Onl - i
�) Q A p
THIS INST AY BE ORDERE • `DISCONNECTED
COMPLETED WITHIN 18 THS
TOTAL
0
Irrigation Booms
Special Inspection
IF NOT
Alarm /Communication
Other Fee
1,
certify
been
the Electrical Inspector, hereby
that the above Inspection has
made.
h -n Date
i
Rough-in /1 jt �r M ] „
A Date
Final I
/ >. o „�
CE USE ONLY
?quest void 18 months from
REQUEST FOftELECTRICAL INSPECTION
•
See instructions for completing this form on back of yellow copy.
"X” Below Work Covered by This Request
EB- 00001 -08
Request Date
/
/a- ' °
7
Fire No.
Rough -in Inspection
Re
Re wired?
,,,,,,iiiiii������
OReady Now Will Notify Inspec-
for When Ready
• No
Street Address, Box or Route No.
70 is /10AGE _ tee R
Range No.
City
E
County
1414 0 771
Section' o.
Township Name o No.
Occupant (PR NT)
P s� A ote n'
Phone No.
Power Supplier
›l.tCO' � Lf,�7R/ L
Address
c
'il/UeFTdX
Electrical Contractor (Company Name)
4��� ��'' , tEc / c
'v
tallation)
Contractor's License No.
a t/' ?f/er — 3
r/
Mailing Address (Contractor or Owner Making Installation)
/01,‘7 - If
Authorized Signature (Contractor /Owner Making In
Phone Number
This request void / , ;
18 months from
D 55931 R�
it Licensed Electrical Contractor
❑ Owner
MINNF,6 STATE BOARD OF EL CTRICITY
Griggs-Midway Bldg. — Room N -191
1821 University Ave.. St. Raul. MN 55104
Phone (612) 642 -0800
I hereby request inspection of above
electrical work installed at:
THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
#
Fee
Service Entrance Size
#
Fee
Feeders /Subfeeders
#
Fee
Circuits
0to200Am
0to30Amps
3p
0to30Amps
Above 200 Amps:
31 to 100 Amps
1
—
31 to 100 Amps
Swimming Pool
Above 100 Amps
Above 100_Amps
Transformers
Irrigation Booms
# co
Partial /Other Fee
%e2 /eV7 REQUEST FOR ELECTRICAL INSPECTION
1p See instructions for competing this form on back of yellow copy.
13 55 9 3 1 -r" Below Work Covered by This Request
New
0
Add Rep, '• Type of Building
Home
Duplex
Apt. Building
Commercial Bldg.
Industrial Bldg.
Farm
D rncn��KPlnw
Signs
This request void 18 months from
Range
Dryer
Furnace
Other
Appliances Wired
Water Heater
Air Conditioner
Other pecify)
Special Inspection
Equipment Wired
Temporary Service
Lighting Fixtures
Electric Heating'
Silo Unloader
Bulk Milk Tank
ther (Spocfyl
Other
Rema rks
Final
Rough -in
(liet `4",(2)
Date
11 -r: f
1, the Ele cat
Inspector hereby
certify that the above
inspection has been
made.