3955 Dodd Rd - Electrical Permitso- - s s 3 ? . ?,vr.r8?
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Reques ate Fire o. ough-In Inspeciion FeQUi.ed Ins c[ion Other Than RougRln
(YOU must call inspeclor when ready) ?ReaM Now ? Will No?iy Inspector
Q-YeS.? ? N. pa?e Reatly
I? licensed contractor ? owner hereby request inspection ot a6ove electrical work at:
Job Atltlress (SVeet. Boe or Raule Na ) Cily
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Section No. Township Name or No. Fange No. Co ny
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Occupant(PRINT) Phone No.
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Power Supplier Adtlress
Elect'cal C nVactor (Company Name) Conuaqots License No.
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M -' g qtltlress ( ont2cror ot Owner Making I lalion)
AuIhorizetl Si re (COntmc w sLallalion) Phone Number
77 "DU-I
MINNESOTA STA AR LECTRICITV THIS INSPECTION REQUEST WILL NOT
Griggs-Mitlway fil m 5-128 BE ACCEPTEO 8Y THE STATE BOApD
1821 UnlversiTy Ave., SL Paul, MN 5510J UNLESS PROPER INSPECTION FEE IS
Phone(612)6dROBpp . ENCLOSED.
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ReQuest Oate Fire No. Rough-in nspection
Repuiretl?
? Reetly Now?Will Notify Inspector
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IXlicensed contractor ? owner hereby request inspection of above electrical work at:
Job Atltlress (SVeet. Box or Route No Ciq
Sectian No. Township Name or No. Range No. Cuu
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Occupant (PRINT) Phone No.
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Pawer SupPiier / -(/-?
Q'O ,?Gf L!/1 Mtlress
Elecvical Convac or (COmOany Name) ConVactors License No.
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Mailing Atltlress (COnrractoror Owner Making Installation7
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Avthon o awre Conlractor;pwne? Maki slall n) Phone Number
MINN SO TATE 80ARD OF ELECTflICITY THIS INSPECTION REQUEST WILL NOT
Grlggs- way Bltlg. - Room S-173 BE AGCEPTED BY TNE STATE 80ARD
1621 U erafly Ave., 51. Paul, MN 55100 UNLESS PROPER INSPECTION FEE IS
Phone 812)6024800 ENCLOSED.
/I/??+ /?0 REQUEST FOR ELECTRICAL INSPECTION
f ? See instmctions lor eompl!llnV fhis form an back oi yellow copy.
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(rg 5 r 9 5 2 "X" Below Work Covered by This Request ?:?.•+?
Ne% A6d Rep: -•-+ TypeofBUiltling AppliancesWired EquipmentWired
Home Renge Temporary Service
Duplez Water Heater Electric Heating
Apt Building Dryer Other (Specity)
Comm./Induslrial Furnace
Farm Air Conditioner
otner (speciry) ConVaclor§ Remarks:
sT vy 1L
Compufe Inspectron Fee Belaw: T /V? ?"/ ' V s!3
# Other Fee # ServiceEniranceSize Fee # Ciraits/Feeders Fee
Swimming Pool 0 t0 200 A.P. ? m 0 to 100 Amps
Transtormers Above 200 _ Amps Above 700 _ Amps
Sigl15 Inspector5 Use Only. . TOTAL
Irriga[ion Booms ?
Special Inspection ?
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS. '
I, the Electrical Inspector, hereby
certify that the above inspection has
been made. Rouqn-m
F;,,ai ?
41 oaW
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OFFICE USE ONLV
This request voitl 18 months imm ? ?
????gg3 REQUEST FOR ELECTRICAL INSPECTION E/ef-00001-?0 'See insVUCtions tar completing ihis torm on back of yellow copy.
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"X" Below Wo!k i,cvered by This Request
Ne Add Rep. Type of Building Apoliances Wired Equipment Wired
Home Range ?I Temporary Service
Duplex Water Heater Electric Heating
Apt. Building D er Load Management
Comm./Industrial Furnace Other (5 ecify)
Farm ir Conditioner
Other (specHy) ContrecYOr's Remarks:,,, ' r
C??fl
Compute lnspection Fee 8elow:
# Other Fee f! 5ervice Entrence Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above ?Dq 30o Amps ? Abov 100 -Amps , D
SIgnS Inspecmr's Use Only: ? TOTAL
Irrigation Booms / 7?
S ecial Inspection
Alarm/Communication THIS INSTALLATION MA D DISCONNECTEO IF NOT
Other Fee COMPLETED WITHIN 18 MONT
I, ihe Elecirical Inspector, hereby
h Rough-in
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certify t
at the above inspection has
been made.
C?t?vl,
OFFICE USE ONLV
This request voitl 18 months trom