820 Lone Oak Rd - Electrical Permitsoooot-os
51$-7 REQUEST FOR ELECTRICAL iNSPECTION . e6- 7so//
"
, See instrucGOns for completing ihis iwm on b»ck of yellow copy.
_4 R?,//.2X- Below Work Covered by This Request
D17R
lNaWlAAdI Rep.1 Type ol Building I AppliOntes Wired I Equipment Wired I
Duplex Water Heater Li,yhtin,y Fixtures
Apt. Buiiding Dryer Electric Heatin
Commercial Bldy. Fumace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm olnt?r necirv Dtne, isne?,?ry1
N ee ServICeEMfenceSize M Fee PeederslSubfeeders a Fr,e Circuits
0 to 200 Amps 0 to 30 Am s AO 0 tn 30 Am ps
Above 200 Amps 31 to 100 Amps 31 to 100 A s
Swimmfng Pool Above 100_Amps Above 700_Amps
Transiormers (rrigation Fiooms Partial-Other Fee
L_1 I Signs Special Inspection js?/ ?I TOTAL?I
Rertwrks '
/ . rI i
I ---° - I I. n sihPect ree lectric I
by
certity thet the above
Final ^ ?? r A D? ?dection has been
reques[ voiA 18
This request void ?/?S/? r?
18 mpnths (rom ?
- DI 71 8 3 z_ Iv Ad
-7 soi/
Bequest Date
?/??? Fire No: Rouph-in InsUec'tion
Re
quired?
jAeady Nowill Notify. InsPec-
l"or Wh
n R
ad
?
Yes O No e
e
y
Licensed Electrical Contracmr I here6y request inspection oT e6ove
ILJ Owner electrical work installed at:
Street Address, Box o?,Route No?
??
So? ?^"w Ciry '
E
ecuo?? o. Township Name or No. Range No. Coun
OccuGant(PRINT) ?
`(YL
W:AL Phon¢ Nn.
u5?- 7179
Power Suppliei
?D/n-ba'c.a- Address /
Electrical Contractor IComp ny me)
v ?s-r,.?. ..? ??- ?4c.e?, Contrar.mr's License No.
`f03 - 7
Mailinp A0ddrress (Contractor or Owner Makin Installation)
!?) Jo S/W 7
Au[horized Signa ure ('CoMractor wner king Installation) Phone Number
\ ??
v" - THIS INSPECTION qEQUEST WILL NOT
MINNESOTA STqTE BOARD OF ELECTflICITV
Griggs-Midwey Bidg. - Noom N-191 BE ACCEPTED BY THE STATE BOARD
UNLESS PflOPER INSPECTION FEE IS
7821 Universitv Ave.. St. Paul. MN 55104
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ?. es-ooo/oi-?os
e?{ , See inslructions tor completing this form on beck ol yellow copy.
? U D 66t29 "X"°Below tiYork Covered by 7his Request
ewl Add Rep. Type of Building Apoliancea Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lightiny Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bidy. Fumace Silo Unloader
lndustrial Bldg. Air Conditioner Bulk Milk Tenk
Farm Oihror peu y MherlSPer.ifyl
t er Uncify Other Othur
ompute lnspection Fee Below
p Fea ServiCeEMrenceSize 11 Fen Fenders/Subleader5 ? Fe¢ Circuit5
L) to 200 Am s 0 to 30 qm s 0 tn 30 An s
Above 200 Am ps 31 to 100 Amps 31 ta 100 1 Am s
Swimming Pool Above 100-Amps Above 100_AmPS
Transformers Irrigation Boorris Partial-"Other Fee
Signs Specfal Inspection TOTAL
F
Remarks aJr. t V /
? ?
/
/f s e?'I'!ew ?.4ea t Y ?e IM
Rough-in ? I?? ?
? e EI '
Inspector, here6y
CBrtify lhBt the aboYB
Final U+'te inspection has been
Q made.
Thle reGuest volA 18 montha from (/ CJr C-,C--/'L- ! /vt-{,,,[_:
This requesl void
ie months from
? 5? 12 9,C o?? ??? e.. ,?•?? //
6VD °o
?nequest Ua1e ? Fire (Vo. Rough-in Insper,tion
ReQUired?
[:]Heady Nuw?Will Nolify Inspec-
? Yes ? No tor When Iieady
? Licensed Electrical Con[racmr I hereby request inspection o1 above
O
Z
wner electrical work installed ac
l
Street Address, Box or Route No. q? ? j
? o ?
1 ?p
1 F c{ty
-e
-
?n
ectioii o. Township Name ur No. Ranye No. County
OccupantlPRINTI Phone No.
Power Supplier
??/\ ? y {
N S L Yv p
Address
Electncal Con[raompany Namel
5'& ?r ?C T Contractor's License No.
Mailing Address (Contractor or Owner Makiog Inst on) ?/?
T?'o ^Ch V/?'/ ' /?/'/i ??/- /
Author' e SiB ture IConir99 tor/Owner Making 1 stallatioa) hone Number
MINNESO7p STATE BOqqD OF ELECTRICIZ"y
Griggs-Midwav Bldg. - Room N-191
7821 Universitv Ave.. St. Paul, MN 55104
Phone (612) 642-0800
THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.