941 Diffley Rd - Electrical PermitsREQUEST FOR ELECTRICAL INSPECTION
4
? See instructions for comWelinp ties torn on back of yellow copy. 1_&
153 2U k, Below Work Covered by This Request
New dd Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specily) Contractors Remark ,,,../1_y1 ??
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Compute Inspection Fee Below.'
# Other Fee # Service Entrance Size Fee # CircuitsiFeeders Fee
Swimming Pool 0 [0 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above 100 Amps
Signs Inspector§ Use Only. TOTAU`_ ?
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby
f Rough-m Date
certi
y that the above inspection has
been made. Final Date
OFFICE USE ONLY
EB-00001-0a
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his request void 18 months from
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Request Date
G Fire No. Rough-in Inspection
Required?
(?ReatlYNpx ? Will Notify Inspector
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I ?K licensed contractor 0 owner hereby request inspection of above electrical work at:
Job Address (Street, go. or Route No .1 City
'4 y I D y ?° ' ?p - a4 K)
Section No. Township Name ar No. Range No. County t
Occupant, , PRINT) Phone No.
Power Suppli//er?'? // Atltlress
Elecvic egtractor (Company Neal
l ?P r mractorb Lkense No.
oy?vE? 3
Maing Addesss Contractor or Owner Making Installation) /I
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Autnonz¢tl nature fCOntr /IOCa r Owner king InstallaLOnl
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MINNESOTA ST E 60ARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NDT
Griggs-MIEwa Bldg. - Room 5.173 BE ACCEPTED BY THE STATE BOARD
1821 Unil Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phan. (61216,12-(1800 ENCLOSED.
Minnesota State Board of Electric
1954 University Ave., St.-Paul, Minn. 55104-Phone 645-7703
REQUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REQUEST
'4-
O 88121
Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For
Home ? ? ? Range ? Temporary Wiring ?
Duplex ? ? ? Water Heater ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dryer ? Electric Heating ?
Commercial Bldg. ? ? ? Furnace ? Silo Unloader ?
Industrial Bldg. ? ? ? Air Conditioner ,?/
,
'p- Bulk Milk Tank ?
Farm ? ? ? List List )
Other _
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COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fee Feeders& Subfeeder • Fee Circuits: # Fee
0 to 100 Amps. 0 to 30 A re '. 0 to 30 Amperes
101 to 200 Amps. 0 re - \ 31 to 100 Amperes
Above 200 Amps. A ' v ' 0 -elm V Above 100 Amps.
Transformers Re teC `4rol ire. Partial or other fee
Signs Sp ? ' Inspection Minimum fee $5.00
Remarks
TOTAL FEE
I, the Electrical Inspector, hereby certify that theabov,$fjinspection has been made. j 60
(Rough-in) 7/9 Date
,Final) w/Date
This request void 18 months from
` -d 7a S:
oro or
TWs request void 18 months from
, :-'? O 88121
Date of this Request
I, as ? Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No. F q/ ca W,0 3d City ~?4'a
Section Township
Which is occupied by 14 bV
(Name of Occupant)
Is a roughin inspection required on this job? No X Yes ? Ready Now Will Call ?
Power Supplier
Electrical
Mailing Address
uthorized Signature
L A
/G NTAJ / IJG
?y (Company Name)
J ! 7741n AJ/,Y,
Range County 47A*'07,19
3161/
Contractor's License No.
ner Making This Installation)
Phone No. (? . 1
or Owner Making This Installation)