2995 Lone Oak Cir - Electrical PermitsF /? /?
3 3 7???? O?} ?
ic SENLY This requesl vaid I6 monthelmm .oiidaeon dare pnnted in ihrs bax?,9G
F
y;l9 7 7
/ ss'?o
PLEASE PRINT OR TVPE CU
Reqwst Dah Roogh-in
mspetlion reqoi 2 ? Ym ? No Inepetlion Olher Thon Rwgh-In- 0 Neady Now fl WJI Call
?a
g? - ost
(Yoo m mil the mspeclor when readyl Dale Reodp
I, licensed contrador 13 owner Mereby requesf inspedion o{ the a6ove ciric w QO
Job Addrezs (Stree Box, or Route No )
2?q ?o?E opK Go?' Gry
?p+C? e
5edion No. Townahip Name or No Range Na. Rre N. County
V
NZ)
OmtpoM Phone N.
N
wC
Power Soppller Address
il
ElecMml ConV
a
cror (Company Nome) Conkador Lwnse No Maskr Lm No. (Plom Elact Only)
u ,
`
t Z 1
Maibn9 Addrms (CoNmaor or 9vnei PeAorming InsMllanon)
E
J -
.
Au on.ed jppNre ConkaclorrPe?i?M onl . -- PFwrrcNo.
_"OW1A-10 6/95 ' STATEBOARDCOPV•SEEINSTRIICTIONSONBACKOFYELLOWCOPY
II 11111 IIII I III III IIIII 111111111111111 RE?UEST FOR ELECTRICAL INS?TIQN (QOt
0? 3 3 7 4 0 4 8 p'?? ?2 v?? m. S-1281c5t. P? MN Home Duplex Apt.8ldg. 7T,-mpSe,ice
Ne Addn
Commercial Indusfrial Farm Remod Re air
Air Cond. Mgt Other:
D er R
"X" above Mre work covered by fhis reqvest. Enfer remarks m this space and on the back ol tbe whde <opy only.
i Er!A-k'J AulL(? - o u7,
Calmlate Inspecfion Fee - Tbis Inspedion Request will not be accepled wdhout Ihe mrtecf fee:
OHier Fee # $ervice Enhanre $ize fce # Circvits/Feeders Fee
Mobile Home Park Stoll 0 to 200 Amps 0 fo 100 Amps
Sireet L}g./rroffic $ig Above 200 Am . A ve 100'ZOb%Amps -
Tronsfortner/Generafor ? INSPECTON'SUSEO A l ? TO AL
$ign/Outline Lig. Xfmr
Alarm/Remoie Conirol ! 1
Swimming Pool I hereb w' ilwr e v'ml insMllaLOn d-nbed herein on Ihe doros emfed
Irtiga}ion Boom qough-In Ook
Speaol Inspedion
Invesfigative Fee fi? ? a
,-Wc tucTALLATION MAY BE ORD D D CONNECT F NOT COMPLETED WITHIN 8 MONTHS.
?j?9lo
.s7? y9
#
P? 66489
Repuest Dare . F?re No
? Rough-ln Inpsection epmretl
(YOU must call mspactor when reaCy) InspecUOn OMer Than Flough-ln
? qea0y Now ? WAI Notly Inspectar
? Yes ? No Uete ReaCy
IKicensed contractor ? owner hereby request inspection of above electrical work at:
Jab ACtliess (Street Box or Rwte No I
?(?y
` Qfy
,
l7
Sechon No Township Name or No Range No County
Occupanl(PplNT) PhoneNo??
Power Supplier Atltlress
Elecmcal ConVactor (
mpany Nama) Coniraclor§ 4cense No
p
Masling ?Atltlrress (GOnlraclor or pvner Making Instellation) /
(:?,,7 U
Autnonzetl Signawre r aclor? nar Meking Ins IaOOn) Phone Numeer
? r
MINNESOTA STATE BMAD F ELECTRICITY THIS INSPECTION REOUEST WILL NOT
Grigga-Mitlwey Bltlg - P m SI73 BE ACCEPTED BV THE STATE BOAflD
1821 University Ave., SL PauL MN 55104 UNLESS PqOPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSEO
s ??? 4 r
66489
REQUEST FOR ELECTRICAL INSPECTION
? See instmctions for completing ihis form on back ol yellow mpy
AL "X" Below Work Covered by This Request
???'? ??G79
ew Atltl Rep ' Typeof8miding AppLancesWiretl EquipmentWired
Home Range Temporary Service
Duplex Water Heater ElecViC Heating
Apt. Building Dryer Load ManagemeM
Comm.llndustrial Furnace Other (SpeCify)
Farm Av Conditioner
Olherlspeciryl GonVacmr's Remarks???
C..t-.
Compute Inspechon Fee Below.
# Other Fee # Serwce Entrance Srze Fee # Circutls/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps ?
Transformers Above 200 _ Amps A i00 _ Amps
S19n5 , Inspactor$ Use Only. TQ7pL
Irrigalion Booms G? ?, S0
Special Inspection ?
Alarm/Communication THIS INSTALLATION MAV BE OR?ER ONNECTED IF NOT
Other Fee COMPLETED WITHIN 78 MONTHS.
I, the Elechical Inspector, hereby R°u9n,n Date
certify that the above inspection has
been made. F,,,ai oa?
OFiICE USE ONLY
ThiS repuest voitl 18 monihs irom
2 6 0-5 7 2 ? OFFIC U'1E NLY This reqonl roid 19 monMs from.alidahon dak pnnled in_Mis bo?
,41t, (o
9 L0) ?
I 3?96
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N
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i oa
# ?
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RLlEA
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ORTYPE
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Raquast Dak 1-
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ll
h Inapedion OlherThan Rough-In ? Ready Now C ill Call
k R
d
D
?J e inspecior w
en rea
y)
?You muxt co
? o
ea
y
4-Wicensecl contracfor ? owner hereby requesf fnspecfion of ihe above elecfrical work af:
Job Address Sveal, 8ox, or Rovb No.) ?
?9?1 toc, e?. cc 5 Ciy
??v?. Zip Coda
a
Sec4on No Township Name ar N. kange N. Fire No. Caonfy 'D?
I 7 ?v ?
Oaupom
-C ? ?c?e,?'?ot?. Phone Na. ??'/M_
PowerSuppiier Address
Elecmml Comranm (Company Namel ,
(
C 1
?
- Gantmnor Lmnze No. Master Li< No (Plonl Eled Only)
ec..
,
?_
ry\ ?
c
Moilvg AAdrese fitConhacfo er Pedorming InstalloLOn) ?
?
1
6 6\
Authanzed Si ` mre omm or O P vg InsMllolion) Pha e Na
1 O ?
EB-00007A-10 6/95/ I STAB011RUCOPY-9EEINSTHUCilON30N8ACKOFYELLOWCOPY
?
1II'I II A111 i?REQUEST FOR ELECTRICAL INSPECTION ?j
h Minnesota State Board of Elechiciry
?? I 1821 University Ave., Rm. 128, SL Paul, MN 55104 * 0 2 6 0 5 7 * Phone (612) 642-0800 ,l???9(0 (WO
Home Duplex Apt. Bldg. Other: New Addn
Commerciol Industriol Farm Remod Re air
Air Cond. Htg. Equip. Wa}er Htr. Load Mgmt. Other:
6 er Ran e Elec. Heat Tem . Service
"X" obove the work covered by fhis request Enier remarks m thn space and on the back of the white copy only.
Calwlore Inspecfion Fee - This Inspection Request wJl no} 6e accepted wifhout the mrred fee:
Oiher Fee ? $ervice Enhance S¢e Fee # Ciraik/Feeders Fm
Mobile Home Park Stall 0 to 200 As ,'? 0 l0 100 Amps k
0
Street Ltg./Tmffi< Sig. Above 200 Amps Ab Amps
Transfarmer/Generator INSPECTOR'SUSEONLY r? J? /? v TOTAL
Sign/Outline Ltg. Xfmr. AQ v
?
Alarm/Remofe Confrol ? V
V
Swimming Paol I hemb mM iha+l ?ns eckd ?ha el a??o ed herrem on the dvka:mkd
Irrigation Boom xough-in
Speaal Ins
edion °
p
Investigafive Fee Finol
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPIETED WITHIN 18 MONTHS.
?
0- 0 1111111949 ? /t/ ro9'?
?
/ ?
??
.
o .
?
AeOUe D ate Fue
Nlb Rou9h-2spection Reqmred
(VOU u call inspactor when raatly) Ins ection O[her Tnanqeugh-In
? Read
Now ??
Will Notiy Inspemor
?
- ? ? ?
y
Na
ves oate Peatl
I?Klicensed contractor ? owner here6y request inspection of a6ove electrical work at.
Job Atltlress (Slreet, Box or Roula No.) ?
K-
1 Ciry
76 (_s??
e-
A I
Section No Towpsnip Name or No Range N. County
Occppap??PPI T) Phone No
PoWer 9u plier Add s
?'
'
.
4
Elacincel Coniracror (Company Namej ?., ontractor's License No
- e 9- 1 4e, c ?ss
Matlmg Atl s(Conbac r M mBlnstallation)
-IIA-tj
?
Auth rz
slur Con torlOw r aking alla6on) Phone Number
? ? - zIlIcZ
MINN
ITY
THIS INSPECTION REQUEST WIL L NUT
6
tl
B
? ?g
BE ACCEPTEO 9V THE STATE 80AR0
21 araity A
G4 UNLESS PROPEF INSPECTION LEE IS
) 862? U ENCLOSED
?J REQUEST FOR ELECTRICAL INSPECTION ,'?`"??? ea-ooooi-os
/D??? ?$ee i?truclions for completing ihis torm on back o( yellow copy
; "?"e/ow Work Ca??red by This Request r T?
Ne Add Rep Type of Bwlding Appliances Wired Equipment Wved
Home Range Temporary Service
Duplez Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (Specif )
Farm Air Conditioner
Other (speoity) Contracbr's Remarks
Compute (nspection Fee Belaw
# Other Fee # Service Entrance Size Fee # Circuds/Feeders F
Swimming Pool 0 to 200 Amps 3 0 to 100 Amps
7ransformers / A6ove 200 Amps ?Y Above 100 -Amps
$1lIS Inspecmr'sUSeOny . Q7pI-0
J
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE OR ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS. •
I, the Electricai Inspecror, hereby
i Rou9n-?? Dale I?
certify that the above
nspection has
been made F?nai Da?e
// j y y
OFFICE USE ONLY
Thle reques[ voitl 18 monihs irom
- 7
31
,N 2 3 s ? ?° ? ?
?V
Req est 'Late Fre o oug -In pechon Reqwretl Inspec"on Other han Pough-In
(YOU must call inspector when ready) ? qeady Now ? Will Noby Inspecror
? g? ? Yes ? No Date Ready
I?'licensed contractor ? owner hereby request inspection of above electrical work at:
Job Atltlress (SVeep Box or Route No ) City
Sechon No TownsM1ip Name or N. Renge No County
Occupant(PRINT) Phone Na
Power Supplier AtlOress
S
Eleclncal Conhactor (COmparry Name) Contradofs Lioense No
? 9 3
MaiLng Adtlress (Conheclor or Owner Making Iristalla6on)
D
Authonzetl n ure (Contracj7g ner Making Ins II [ion) Phone Numher
MI SOT STATE BOAFO OF ELE IqTV
I THIS MSPECTION REOUEST WILL NOT
G gsMi ay Bldg. - Hoom 5-128 II ? I? I II I I I I I I I) 6E ACGEPTED BV THE STAiE BOARO
i621 Univ rsity Ave., SL Paul, MN 55109 ? UNLESS PqOPER INSPECTION FEE IS
Phone(6121692-0800 , ,
,
? ENCLOSED
/J-?_73 / REQUEST FOR ELECTRICAL INSPECTION ^ e.ep-ooooi-os
t .s ?? ? See instruclions for complebng this tortn on back of yellow copy SV/Q 7
??/0??/9? "X" Below Work Cove-;d by Thrs Request .,it.
Ne Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heahng
Apt. Building Dryer Load Management
Comm./industrial Furnace Other (Specdy
Farm Air Conditioner
Other (spemly) Contractor's Remerks
Compute Inspection Fee Below.z7? V 3 ¢w
# Other Fee # Service E rance Size ee # Circuits/Feeders Fee
' Swimming Pool 0 to 200 Amps to 100 Amps
! Transformers ltsv Above 200 Amps Above 100 _Amps
SI f15 Inspec[ar's Use Only TOTAL
Irrigation Booms
?
S ecial Ins ection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspeclor, hereby Rough+n Dale
certfy that the above inspection has
been made. Rinei
(
OFFlCE USE ONLY
This request void 18 rtwnths irom
Fequ st Date Fire No Rough- spechon ReQmretl Inspecbon O[herTM1an Rouqh-In
1 57 (VOU must II inspector when ready) ? Ready Now [] Will Nohfy Inspector
?
Yes
No Da?e Reatly
Iicensed contractor ? owner hereby request inspection of above electrical work at
Job Atltlress (Sleeat, Box or Route No ) Ciry
S
Section No Townstlip Name or No Range No Counly
P
Omupant(PRINT) Phone N.
Power Suppiie? Atltlress
5
ElecVical GonVactor (Company Name) ConUaclor's L¢ense No
D 03?
Maihny dtlress (Connactor or Owner Making Installalion)
g--f?-
Authonze ontraclor/Ow r akm honeNumher
MI ES A STATE BOAHO OF ECTHICITY i
0
6 THIS WSPECTION PEOl1EST WILL NOT
gs dway eiUg. - qoom 5128 l 1 11 I?I I I
I I
II
6E ACCEPTED 8Y THE STATE BOARD
21 University Ave., St Paul, MN 551 W UNLESS PROPER INSPEGTION FEE IS
Phone I61218Q2-0800 FNCI ORFO
REnUEST FOR ELECTRICAL INSPECTION Ee-oooai/-o'ys
? ?oo. S2 msltuc0on5 for mmpleting Ihis form on back ot yellmv copy
"X" Below bl!ork.Coyered by This Request ??•
Ne Add Rep Type of Bwiding Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Fumace Other (Specify)
Farm Air Conditioner
Olhar (speay) Contraators Remarks
Compute Inspection Fee Below: ?LTIAMV 3 UJ at,5 if-x
# Other Fee Service Entrance Size Fee # C?rcuits/Feeders Fae
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200_Amps Above 100 -Amps
SI f1S Inspector's Use only TOTAL
Irrigation Booms
Special Inspecnon ?J
AIarMCommunication THIS INSTALLATION MAY BE ORDER CONNECTED IF NOT
Other Fee
• COMPLETED WITHIN 18 MONTHS. :a
I, the Electrical Inspector,
hereby
certify that the above inspection has
been made. R°°9n-'"
Fnal .? ate
Date
OFFlCE USE ONLY
U V
This requesl void 18 monihs irom
2 21- 8 31 0 OFFI E US ONLY This reques, void 18 months from vaLdmmn dote pnnted in Ihiz bax
ia/?9
5'
.
' o
PLEASE PRINT OR TYPE
Reqoest Dah Ro?gh-in inspeclron re u 2 I$,"Yes 0 No Inspedmn Oiher Than Raaghin Q Reody Now?Ndl Call
/0 (You must call the inepedorwhen ready) D.I. Ready
I, Er Iicensed coniracior ? owner here6y request mspedion of fhe a6ove electncal work af'
Job Pddrenu jQSNeeq 9ax, or Rome No I //?/7 ` /?ry/
q?O/?2 (/4!? VIrUL? Gry
Ea Zip Code
Secbon No. To»nship Name or Na. Ronge N. Fire N. Counry
Occ?/ ?,/1 <( /?'
? Phone N.
E l?Ptl$StN
NT6Yp(Tb
Powe
pplwr
`/ I r
?Q1?6 ¢Gtr. cr
Pdd
?i oo -aao
•
?
MAJ
EIeeM Contmdor ICompony Name) anhatlor Lcense No Maskr Gc No. (Planl Elecf Only)
MoiLng ss(Cant orOwnerPedorming Insbllanon)
lwfhorizad Si9 Ni ar 0 dommng Installa Phone No
_ Tj EB-owpr?i0,s/w,? ??EBOARDCQqy?Seg INSTPUCTIONSONBACKOFYELIOWCOPY
II?I REQUEST FOR ELECTRICAL INSPECTION
II I II I(.2 I' II I I II Minnesota State 8oard of Electricity ??a1
uJ? 1821 University Ave., Rm. 5-128, St. Paul, MN 5 04 ?f
s 0 2 1`8 3 1 1 * Phone (612) sa2-0soo /?f?9,5 '"
Home up ex Apt. Bidg. OlFier: New Addn
J(j Commercial Indushial Farm Remod Re air
Air Cond. Hig. Equip. Wa}er FNr. Load Mgmt. Olher.
D er Ran e Elec. Heat Tem . Service
"X' abwe the work rovered by this request Enfer remarks in this space ond on the back ol the whde mpy only.
Cakulate Inspection Fee - 7his Inspecfion Requesf wrll not be a<cepted wifhouf the <orrecf fee-
OlFier Fee S Service Enhance $ae Fee # Circuils/F rs Fee
Mobile Home Park Stall 0 fa 200 Amps 0 to 100 Am Oo Al' O
Sheet Ltg./Tmifi< Sig. ? Above 200i Amps p," Above 100 Amps
TransformedGenera}or IqgPECTOp'Sl15EONLV TOTA 1
?
Sign/Outline Ltg. Xfmr. ,vv
Alarm/Remofe Control e wit P2 j, SO
$wimmingPool `io<<d40 Z0.q
I hem cerli that I ins eded the elecmcal inekllafion denrnbed herein on the daks sMw
Irrigaiion Boom Roogbin Dok
eciallns
edion
S
p
p
Invesiigatrve Fee Final
THIS INSTALLATION MAY BE ORDERED DiSCONNECTEDW ilitiM C 16 MONTHS.
221e82*V OFFICE SE ONLY This reqvest void 18 monihe from wlidanon daM pnnred in fiis 4F911
?
PLEASE PRINT OR TYPE
Reqirest Dota Rough-m mepenian reqm ? Ves 'P!?No Inspacion OIfKr Than Rough-Im [] Reody Now Will Call
?
(You mus! mll Ihe mspacbr when readyl 1 eadp
I, licensed con}mdor ? owner hereby requesi mspedion o e o ove e edric work at:
lob Mdre ( sz (Skeet, Bos, or Rauk Na.) //??
al, 7 ' ?ONe 04^ V,rClfi Gryr1-? Z? e
Secnon No. Township Name or No kanga No Fire Na. Caonry /
L
Occo nt ?y ( Phone N.
Power pplier
? Pddr ss OO aV
l
??G
?la QG lMleJ
ElecMml ontroclor (Compony ome) C haclor license No Nwaxr lic. No (Piont Elect Only)
e
,? e ; ?
MaAing Add s(CoMro r or ner Pe rming Insbllanon)
w
4
N.
AulFwnud ignoN ? or er PeAo lofion) PMne No.
EB- A-10 6/9 BOA40 ddlof -SEEINSTRUCTIONSONBIICKOFYELLOWCOPY
? REQUEST FOR ELECTRICAL INSPECTION?t
Unive State
III?II I II I III) Minnesota
AvearRm S?, cSt. Paul, MN 55104 ? e
* 2 2 1 8 2 7 9* Phone (812) 642-0800/IM5
Home - up ex Apt. Bldg. Other: New Addn
Commeraal Indusfrial Farm Remod Re air
Air Cond. Htg. Equip. Wafer Hir. Load Mgmt. Other:
D er • Ran e Elec. Heat Temp. Service
°k' a6ove the wari: covered by this requesf. Enter remarks in this space and on the bock of the white mpy anly.
Cafculafe Inspecfion Fee - ihis Inspedion Requesf wdl nof be accepted wdhouf the mrred fee:
Olher Fee i` Servire EMrance 5've Fee it Circuits/Feeders Fee
' Mobile Home Park Stall 0 to 200 Amps 0 fo 100 Amps Ozj
Street Lig./Troffic Sig. Above 200 A Above 100 Amps
Transformer/Generator INSPECTOPBUSEO TOTAL
Sign/Outline Lfg. Xfmr. c?
Alarm/Remote Control `?.p?? l,• /Q, ?J'0
Swimming Pool sa
I here ce ' thot I ms ed Nre alednml installanon desmbed ir,ain o? 1
Irrigofian Boom Rough-In k
Speciol Inspedion
Investigative Fee Firwl i
? ?
THIS INSTALLATION MAY BE OHDERED DISCONNEC IF NOT COMPLETED WITHIN 18 MONTHS.
2 4 ? 23S
15
0
' 7
?
#
-
/X/
i?
J
Req est Date Fne Roug -I Inspechon Feqmretl Inspeclion OtherThan Rough-In
(YOU s? call inspec?or when reatly) ? Reatly N. ? Will Noby Inspector
? es ? No Date Ready
I EPlicensed contractor ? owner hereby request inspection of above electrical work at:
Job Addren (Slreet, Box or RaNe Na ) Ciry
?
Seclion No Townshlp Name or No. Range No Couny
Occupanl(PRINT) Phone N.
BgrtsT- 5 A/
Power Supplier Atltlress
5 :5nZZrr
Eledncal Conhactor (Company Name) Contraclors License No
c'_-- 1a3?
Mailing Address (ConVactor or Owner Making Installation)
?IAQ
Aulhonzetl aWre (COnhac[or/ wner king Installatio Phone Number
MI 50 STATE BOARA OF EL TflICRY
I
I THIS INSPECTION REOUEST WILL NOT
ga-M' way BIAg - Poom 5128 11 111 1111 111 111 I I I? I I I I ? ? I I II BE ACCEPTED BY THE STATE BOARO
1 1 University pve., St Peul, MN 55f09 UNLESS PROPER INSPEGTION FEE IS
Phone (812) W2-O800 .
r ? ENCLOSEO
? REQUEST FOR ELECTRICAL INSPECTION Es-ooaoi-os
0, See iretmcbons for compleLng this lortn on back ot yellow copy
"X" Below Work Coverer+ by This Request
Ne Add Rep Type of Building Appi?a?,.,_ _. red Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt Bwlding Dryer Load Management
Comm./Industrial Furnace Other (Specify)
Farm Air Conditioner
Other (specity) Coniraoror's Remarks
Compute Inspection Fae Helow: 3
# Other Fee Service Enirance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps ] 0 to 100 Amps $'
Transformers Above 200 Amps Above 70 -Amps
$I nS Inspeaar's Use Only.
OTAL
Irngation Booms /
S ecial Inspection
. AI rm/Communication THIS INSTpLLATION MAY BE ORDERED DISCONNECTED IF NOT
ther Fee , COMPLETED WI7HIN 18 M
I, the Electncal Inspector, hereby
t
th
t
t
h
b
i
i
h Rough-m . oa J
?
cer
i
y
a
ove
t
e a
nspecf
on
as
been made. Finai / oa
OFFlCE USE ONLV
This repuesl voitl 18 monfis trom
p?, 5 ??a yya?yy
? -?235
?
Requ s[ Date Fre o ug -I Inspeceon Reqwrea Inspedion herThan Rough-In
1?? Q? Q?? (Vou mus II mspector?vhen reatly) ? ReaOy Now ? Will No6fy Inspector
r t Yes ? No Date Reatl
Iioificensed contraclor ?owner hereby request mspection of above electrical work aT
Job Atltlress (Street, Box ar Route No ) Cily
G f-AZA1W
Sec[ion No
"Townehip Range N. County pft%imt
Occupan[(PPlNT) Phone No
F_s5
PawerSuppher Atltlress
Elecmcal Comractor (Company Name) ConVac[or'a License No
? 4-n
Mailing Address (Coniractor or Owner Making InstallaLOn)
S-6-/ i
Au[honxetl g aWre (COnttac[or/ wner aking I IIaL ) Phone Number
MI SOT STATE HOAPU OF EL TPICITY THIS INSPECTION PEQUEST WILL NOi
G ga-MI y 61tlg - Room 5-128 I I ?I
! I? ? I I ) I I ED BY THE STHTE BOARD
II
C
P
niversiry
t 21 U Ave., SL Paul, MN 55104
UNLESS PROPER WSPECTION FEE IS
Phone(6121 642-0800 ' ENCLO
E
?
REQUE9T FOR ELECTRICAL INSPECTION '- ee-oaooi-os
J111, See insimcbons for completing this form on back of yellow cnpy
"X" Selow Work Covered by This Request
Ne Add ep. Type of Building A plianoes Wlred Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electnc Heating
Apt. Building Dryer Load Management
Comm./Intlusfial Furnace Other (Spea )
Farm Air Conditioner
Other (specily) Contraclors Remarks
Compute lnspechon Fse Below: 77 4 u 14CF&Z
# Other Fee # Service Entr nce Size Fee # CircuitslFeeders Fee
Swimming Pool 0 to 200 Amps ?Q 0 to 100 Amps
Transformers S Above 200 Amps ve 0_Amps
SI OS ' Inspecrors Use Onry / T TOTAL
Irrigation Booms ! ?J ? ?
Special Inspection
Alarm/Communication THIS WSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
V 'Dther- „S COMPLETED WITHIN 18 MON S.
?
I, the Electrical Inspector, hereby
b Ro.qn-?? ? oace /??? q?
cedity that the a
ove inspection has
been made.
Flnal
[e
OFFICE USE ONLV
This request void 18 monfis trom
?-?
?
• -?a
o ? # ? ? o ??
,
;
. ,
Rs Oale Fire No Roug Inspechon Reqwred Inspection OlherThan Rough-ln
(VOU m?u,sly? II inspacfor when reatly)
'
? ? Reatly Now 0 Will Nottly Inzpector
No
?
Yes Date Featly
Ili?<censed contractor ?owner hereby request inspection of above electrical work at:
Job Address (Street. B. or qoute No ) Crty
a S G
Sectron No Township Name or No. Fange No County
. 9
Occupant(PRINT) Phone No.
PowehSUpplrer Ptltlress
L 3f.Y?
Elecmcal Contractor(COmpany Name) Contracmr's Ucense No
!03
Mailing Atldress (COntracfor or Owner Meking Inslallation)
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Authonze ig ature ContrzctotlOwner Making Ins Uon) Phone Numper
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E SO STATE BOAHU OF ELEC RICRV
0 THIS INSPECTION REOUEST WILL NOT
ay 81dg. ? Roam 5428
199 I II [1 11111 111 1111 ? I I I ? BE ACCEPTED BV THE STATE BOARD
1821 Uni nity Ava.. SL Paul, MN 55106 UNLE55 PROPER INSPEGTION FEE IS
Phonel612)fi42-0800 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION Q
E???ls
See msvuaions tor complebng iNS form on back ot elbw copy "X" 8elnw Work Covered bv This Reauest .I ---- ----- -- - - -- ---
Ne Add Rep. Type of Building AppliaL,°gs Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt Building Dryer Load Management
11/ Comm./Industrial Fumace Other (Specify)
Farm Air Conditloner
Dlher (spemly) ConVactor's Remarks
Compu[e Inspechon Fee 8elow_
# ' Other Fee Service ntrance Size Fee # Circuiis/Feeders Fee
Swimming Poal f D to mp o 100 Amps
a Transformers W Above 200 Amps _Am s
$I ns Inspector's Use Ony TOTAL
Irrigatiqn Booms `Q I _ OS`
S eaal Ins ection
? .
AlamyCommunication THIS IN57ALLATION MAY B DISCONNECTED IF NOT
ther Fee COMPLETED WITHIN 18 MON
I, the Electncal Inspector, hereby
tif
th
t
h
h
b
i Roughm / r o81g? `? f,?
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cer
y
a
ove
nspechon
t
e a
as
been rtrade. F?nai aie
OFFICE IlSE ONLY
This request void 18 monlhs Gom
o?? 9s9 3 9 0 1e
Reques Date Frte o Rou ' ^^.twn Reqmretl Inspec4on OlherThan Roughln
I
I
(YC ,,. ispec[0u when reatly) 0 Reatly Now [3 Will Nottly Inspector
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J Yes
N. pale Reatl
Icensed contractor ? owner hereby request inspechon of above electrical work at:
Job AOtlress (Sireel, Box or Route N. )
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Sac?ion No Township Name or No Ranqe No County
Occupent PRI T) Phone No
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Power uppher tlGress
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Elecincal ConVactorCOmpany Name) Contreclois Ucens o
.D oa s`S
Maibng Adtlress (C clor or Ow Making Installa0an)
authonzetl ignatu onir ctonOw r Making Inst wn) ? Phone. Number
• S^ ?7/ / - / /?O?
MINNES STAT EL CTPICITV THIS INSPECTION REQUEST WILL NOT
Griggs- way g. - qoom S4Y
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1111 BE ACCEPTED BV THE STniE BOnRD
1821 Un verelty Ave., St. Paul, MN 5104 UNLESS PROPER INSPECTION FEE IS
Ppone1612164I-0800 _ ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION ?r?•R° Es--as
? See instvclians for complebng Ihis form on Deck of yellow copy (ze
?-°
"X" Below Wovered by This Request
Ne Adtl Rep. Type ot Bwlding Appliances Wired Eqwpment Wved
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other Specify)
Farm Av Conddioner
Olher(speafy) ConVactors RemaMs
Compute Inspechon Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fae
Swimming Poal 0 to 200 Amps t 100 Amps p
Transformers Above 200 Amps Abo 100 -Amps
Si nS Inspemors Use Only ' TOTAL ?y Q
Irrigation Booms ??•OU
. - p
Special Ins ection
Alarm/Communication THIS INS7ALLATION MAY BE ERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electncal Inspector, hereby
tif
th
t th
i
b Houqn-in Dale
cer
y
ove inspect
a
e a
on has
been made. Fnei o
`Co
DFFICE USE ONLY TNS request void 1B months imm
3 3 7_ R} 05 ? ?FFl USE NLY This requmt vaid 18 months tmm validonon date pnnkd in lhis 7box?? /
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PIigASE PRINT OR TYPE lI
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Request-ore Rough-in inspecnon require ? Yes 0 N.
ffiJ
Inspecflon Other Than Rough-In [] Reody Now,:?ill Call
(Youmuafwlllheinspedorwhenreody) Raady.
LA"
licensed contrador ? owner hereby request inspeciion of
e above ele ical
Gry
Job Address (Sveet, 9a; ar
Rout
e N. I 1/12V96&
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SMion No. Township Name or No. Range No iire No. Counry
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Occvpom Phane
No
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Povrer Supplier Addmss
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Elecm I Convocror (Company Name) Conhatlor Lcense Na. Maskr La No (Plam EIM. Only)
k C, ' ? G 2
aiLng Pddreas (Conkocmr ar O+ner PeAarming Imwllnnon)
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d Sig?wNre ?Conho or Oome e rming Ilohan)
Auihonss Phone N
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EB-OOOOlA-10 6/95 STpTEBOAi70COFV•SEEINSTNUCTIONSONBACKOFYELLOWCOPY
III I pl II I II III IIIII I II III ? III II?II 1?821QUniversitY Ave., Rm SR 28, St.IPauIP, MNTSSO104??W-r-w-P,
* 0 3 3_ 7_ 4 0 5 5* ?+hone (6+2) sa2oeoo g?7??n(0 Home Duplex Apt. Bldg. Other: New Addn
Commerciol Indusirial Farm Remod Re air
Air Cond. Htg. Equip. Water Hfr. Laad Mgmt_ Other: -?
D er Ran e Elec Heaf Tem . Sernce
"X" o6ove the woik mvered 6y ihis requ t. Enter remarks in this space and on the 6ack of ihe whde mpy only.
1E,tVOs4T gw?LY?o?.-T -,va* 34tZ0
Cvlculote Inspection Fee - 7his Inspection Request wJl not be accepted wdhout Ihe cortecf fee:
Olher Fee # $ervice Enhance Size Fee # Cirwils/Feeders Fee
Mobile Home Park Sfall 0 to 200 Amps l lq, p 0 to 100 Amps
$treet Ltg./rmHic Sig Above 200 Amps 100 Amps
Transformer/Genemtor s INSPECTOR'S USE ONLY ? TOTAL
Sign/Ouiline L}g. X(mr. 17,
Alarm/RemoTe Control
Swimming Pool i h>reb "nl oi i 'ns «i,d the da?m Ilohon desrnbed heren on Me dmes emKd
Irngation Boom Ro?gh-In P Dam
$pecial Inspection
Investigative Fee Ft o? T.O
THIS INSTALLATION MAY BE ORDER ISCONNEC D IF N T COMPLETED WITHIN 1 MO HS.