2985 Lone Oak Cir - Electrical PermitsREQUEST FOR ELECTRICAL INSPECTION
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/¢ 7 ?$ee ins[ructions for rompleting Ihis torm on bdck of yellow copy. g[??v?•/
•"X" 8efow Work Covered by This Request
A Add Rep Type of Bwlding Appliances Wved Equipment Wired
Home Range Temporary Service
Du lex Water Heater Electnc Heating
' Apt. Building Dryer Load Management
Comm./Industnal Furnace Other (Speafy)
Farm Air Conditioner ?
O[her (specdy) Contractor's Remarks
Compute Inspection Fee Below.
X Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps Od
Transformers t Above 200 aAmps . BV, 00 _Amps
? SI OS Inspectar's Use Only - ` TOTAL 5
- Irrigation eooms ?? Vp
Special Inspection
? Alarm/Communication THIS INSTALLATION MAY BE OR DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electncal Inspector, here6y
if
h Roughin / oal ?
cen
y i
at the above inspection has
been made. Final oaie
OFFICE USE ONLY
This request vaitl 18 manNS irom
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Reque Date
? Fve N. Ro gh-In s ction ReqmraC
(VOU us I inspector when ready) Inspecll n 01her Th n ou9h-In
0 Ready Now WJI Notib.fdspec?or
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? es ? No Date Raed «?
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I licensed contractor ? owner hereby request inspechon of above ele c
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Jab Atldrese?lStreet eox Routa No ?t
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Seption No Township Name or No, Range No C my
Occup. n? T
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PowerSUPplier ? , G? " ? nc ??? ?l•
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Electncal Conlractor (Company Name)C
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• Contrector's License No
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MaAing Atltlr (COnhac r Owner aking Installation)
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Authoni i erJ rado00w e? Makin lell on) Phone N?umber
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s B?dg. -qoom 9F BEGTNICITY III ?I II'I I II (I I I I I I I II ? gE I ACCEPTEO I BV THE STATE 80AD
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18 Unival4'ily Ava., $L Pau1?iN 55106 yF, '1II
Phone 16121 602-0800 III N ENCLOSED OPER INSPECTION FEE IS
i REQUEST FOR ELECTRICAL INSPECTION .5?
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Minnesota State Board of ElecUicity
? II IIII ( II IIN ?.<.,
1821 University Ave., Rm,.cS/128 $t?Paul, MN 55104
•* 0 3 7 8 6 2 ?c Phe :u (612} 642-0800
Home upex Apt. Bldg Ofher: New Addn
ommercial Indusfrial Farm Remod Re air
Air Cond. H?g. Equip. Water Hfc Load Mgmt. Other:
D er Ran e Elec. Heot Tem . Service
"X" obove fhe work covered by this requesf Enter remarks rn thrs space and on the ba<k of the whde copy only
-2:n1,09v 3f4w 5F-V?. 136-Qu1 ae-s )4- IVWTF{L,
Calcula}e Inspection Fee - This lnspechan Requesi wdl nof be accepted wrthout the mrrec} fee:
OlFier Fee $ Service Enhance Size Fee # Circuils/Feeders Fee
Mobile Home Park Siall 0 to 200 Amps 11 0 l0 100 Amps
S}ree} Lfg ITraHic Sig. A6ove 200 Above 100 Amps gW
Transformer/Generaior INSPECT USEONLY ? TOTAI,
W
Sign/Outline L}g Xfmr. 1•
? I(?
Alarm/Remofe Confrol
$wimming Pool I hereb cem thol i d e ele 'ml mpa n descr?bed herein on fhe da?ea sMled
Irngation Boom Raugh-In ?re
Specioi Inspecfion
Investiga}ive Fee
hn /
Darc1 ?,r
/
THIS INSTALLATION MAY 8E ORDERED DISC D WITHIN 18 MONTHS.
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l?dan darc kdp Mis bax
OFFIC USE NLV This qvest vo IB mhs ham w
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PLEASE PRINT OR TYPE I ?
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Reyrcst Dole - .Rough-in inspedton reqm Q Yes ? Na Inspec4on Olher Than Rovgh -In? Ready Now Q WAI Call
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(Yoa mus, mll Me inspeclor when ready) Da R dy
I, ? licensed contrador Q owner hereby request inspedion of ihe a ove electri< ork af:
kb Address (51reet, Bon, or Roole No.) Gry
2 m
Section No. Township Name or No. Range N. Fim No Counry
OrcoPanf Phone N.
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PowerSuppliei Address
ElecMml Conkador (Compony Nome) Conlmnoi hama N. Mashr Lla No (Plom Elact. Only)
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Mailieg/ddmu ConkocorarOwnerPedoiminqlnsmllonon)
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AuMa' rOwnerPerfo Iris anon? PhoneNo.
8
W66WiA-10 6195 'STATEBOAfiDCOM-SEEINSTRUCTIONSONBACKOFYELLOWCOPY
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G O J OFFl?USE?pp? ihis reqvest void 18 monihslmm wlidanon daM pnnrod m fiis box ?
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PLEASE PRINT OR TYPE
Request D. Ro?gh-1n insp<tlton r red2 es ? No Inepecnon Olher Thon Rough-In- 0 Ready No ?ill Coll
(Yoo musl mll the mzpedor when reody) Duk Reody
I,*0 licensed cantracior 0 owner hereby request inspeciion of the above eledrical wark ai:
Job Address (Shee1, Box, or R ote No ) I
? Ciry Zip Code
Ne rd
Sgdion No. wnship Nome or No Raiga N. Fire No. Counry
Occ7!E?e?s ?
N Z?ro ss i N Phone N.
Pa., s
I,e, Add , oo - a
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ElecMCa nlro_cmr (Com ny Name) onhanor License Na. Mas?er lic No (Plant Elecl. Only)
Mailinq drms (Contmnor or Owner PeAormin n mllaxon)
PMhonxed ro ? ar Own PeAoiming lallanon) Phor?e No.
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EB-0O001h0/6/95 /' ' //ffiATEBO6GSjIPY-SEEINSTRUCTIONSONBACKOFYELLOWCOPY
• II III M83 REQUEST FOR ELECTRICAL INSPECTION rMinnesota State 8oard of Electricity
1821 University Ave., Rm. -12 , St. Paul, MN 55704 0 2 2 L 3* Pn«ie (612)642-0e004/95
Home Duplez Apt. Bldg. 5mr-1 New Addn
Commeraal Indus}rial Farm Remod Re air
Air Cond. Hfg. Equip. Wofer Hir. Load Mgm}. Other:
D er Ran e Elec Heat Tem . Service
"X" above the work mvered by Ihis repuest. Enter remarks in tbis spvice ortd on the 6ock of ihe whife copy only.
Colculote Inspec}ion Fee - This Inspecfion Requesf will not be occepted wrthouf fhe corced iee:
Olher Fee 31` $ervice Enlrarwe $ize Fee # Circvits/Feeders Fee
Mo6ile Home Park Stall 0 to 200 Amps 0 ro 100 Amps d
Stree} L}g./Traffic Sig. ? Above 200 a Amps Q,D0 Above 700_Amps
Transformer/Genemtor t
aV 0 INSPECTOP'5USEONLY TOTAL
$ign/Oufline Ltg. Xfmr.
?O
Alarm/Remofe Control
r '
,J
?ara?
Swimming Pool r
I hereh cem fiot I ins Med the elecmc on des on die dv smkd
Irri9ation Boam Rough-In I 'r d
Special inspeciion ? ?
Investigative Fee Fvwl -
? Dal
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p
THIS INSTALLATION MAY BE ORUERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
j(fl I I? ? IIIII 1111 REQUEST FOR ELECTRICAL INSPECTION aw- Minnesota State Board of Electricity
1821 University Ave., Rm. S28, S. Paul, MN 55104
I*N0 2 1 8 2 7Phone (612) 642-OSW ??)f3 Ho
me Duplex Apt. Bldg. Ofher: New Addn
ommercial Indushial Farm Remod Re air
C
v Cand. Htg. Equip. Water Hfr. Load Mgmt. Other.
D er Ran e Elec. Heaf Tem . Service
;'X" abave the work covered by this request Enier remarks in this space and on the 6ock of the whde copy only.
Calcatate Inspecfion Fee - 7his Inspec6on Request wdl not 6e accepfed wdhouf the correct fee.
Olher Fce # $ervice EMrarwe Sae Fee # Circuils/Feeders Fee
Mobile Home Park Stall 0 ro 200 Amps 0 to 100 Amps ?
Sfreet Ltg./Traffic Sig. A6ove 200 Amps Abov 00 Amps
Tronsfortner/Generator INSVECioR'sUSEONIY TOTAL.,'?' ?.SZJ
Sign/Outline Ug. Xfmr. u
?
6•
Alarm/Remote Control
$wimming Poal I hereb rem ihm I ?ns eeed the elechmal insi on des bad hermn on the dvks zmted
Irrigation Boom pough-I.
$pe<iallnspedion
lovestigofive Fee Dfl_ ?P
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETEO WITHIN 18 MONTHS.
OP CE U ONLY This requeat void 18 monl hs from volidobon dob pnnkd in thiz ho[
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PL.EASE PRINT OR TYPE
ReQoesf Dare Aough-in inapection req r B ? Yes P!kNo Inspenion Olher Thon Rough4? Reody Now Will Coll
(You must mll the irapecrorwhen ready) Dale Reody
I; licensed confrador ? owner hereby requesf inspection of ihe above electrical work at:
lob Addrms (Sheet, Box, or Rwle No )
A 98j7 C.C.,? c?,?k C?,rcle Gry
E-a
e- ,) Zip Code
Secnon No Townahip Name or No. Nange N. Fire No. Counry
p p L i i ??? Q
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PavrcrS plier ?
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Eladncv Commtlor (Company Nomel Commnor Licanse No. Muster Lc No. (Plvnt Elee. Only)
Mailing Ad a(Contmtl r r Owner P orming Insmllonon) ?
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AuMorized nahn (CkWdt r or Ow Pe
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Phone No.
EB1A-10 6/9 TATEBO COPY-SEEINSTXUCf10N30N6ACKOFYELLOWCOPY
(III IIIIII I I II? ?! II I' I? II
* 0 3 1 9 4 0`6 5'
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REQUEST FOR ELECTRICAL INSPECTION
Minnesota State Board M Electricity
1827 University Ave., Rm. S-128, St. Paul, MN 55704
40
Pna,e (612) eaz-oaoo 9?.?D/9l0
Home Ouple:, ApG Bldg. Ot --
?~ f New Addn
? Commemal Indusfnal farm Remod R.
oir
Av Cond. Htg, Equip. Waier Hh. Load Mgmt Ofher:
Dryer Ran e Elec Hea} Tem Service
"X" above fhe work covered 6y this request. Enfer remarks in this space and on the back of fhe white copy only.
Calculafe Inspedion Fee - This Inspection Request wdl nof be o¢ep}ed wdhout the mrrecF fee-
Olher Fee A $ervice Enhance Sae Fee # Circuils/Feeders Fee
Mobile Home Pork Stall == 0 to 200 Amps ? 0 fo 100 Amps S^S;
$treef Lfg,/Traffic $ig. _ Above 200 Amps Amps ?
Trans4ormer/Generaior ' INSPECTOR'SUSEONLV TAL
Sign/Ou}line L}g. X{mc
Alnrm/Remote Control
$wimming Pooi i here ?em Mar i. ?d th 'mi io ?n ed Frer,,n on Ma da?.mled
Irrigafion Boom Rough-In Date .
Special Inspechon
TH
nvestigotrve fee
IS INSTALLATION MAY
, S'Q
BE DR Final ?ate
g t
DEREO UISCO WITHIN 1 MONT .
319 - T v ? OFFlC?E USE ONLY This request void 18 monMs irom mlidalion dale pnnted in Iht 6ai ?/ C
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VLEASE PRINT OR TYPE /a I 11
Reqomt Dab Rough.in inspection raqw s ? N. Inxpedion Other ihan Roogh-Iq. ? Ready Now iil Coll
?Yoo mvst wll Aa mspecbr whan reody) b Ready. ? dQ
I, Wficensed can}rador ? owner here6y requesf inspedion o ?he above e ncal O O
Job M
dross (Sfreet, Box, or Raute Na.) Gry ? e
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L&N
Sedian No Townehip Name or No, Raege No Fim No. Counry
OA-W-OM
Ocaponl
Awalof Phone N.
Power$opPlmr Mdress
N
Elednml Contracror mpany Noma) Conkawr Lcenza No Mamr Lc. No. (Plant Eiect Only)
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MaiLig Mdrezs (Com.ocmr o. O.mer Pehoimng Inzbllanant
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AuMonm i Canhador or Owpef Pador i g Inst afionl PM? No. _
,AW74106/95 SfATEBOABDWPV•SEEINffiRUCTIONSONBACKOFYELIOWCOPY
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