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3869 Dolomite Dr - Electrical PermitsREQUEST FOR ELECTRICAL INSPECTION EB-00001-03 Sen instructions for completim s form on back of yellow copy. ?y Y `3`5385? X"" 621ow Work Covered by This Request 101 30 ( 0 a ew Add Rep. Type of Rullding Appliances Wired Equipment Wired Home ?Iz Range Temporary Service Duplex Water Floater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Fumace Silo Unloader n(lustrial Bldg. Air Conditioner Bulk Milk Tank Farm O n the, IS nerifvl t ier Sped lv O Othor Compute Inspection Fee Below 9 Fee Service Entrence Size 9 Fee Feeders LSubfecdele 4 Fee Circuits 0 to 100 Am s 0 to 30 Amts ';° 0 to 30 Amps 101 to 200 Amps 31 to 100 Amps 31 to 100 Am Above 200 Amts Above 100 Amps Above 100_Arri Transformers Remote Control Circ. Partial/Other Fee Signs Special Inspection s `? TOTA z - Renurrks n 15-71 1 io L E.- Rough-inl t t Date U ?a Eletl Final y hat the aybove )?'''T ection has been / / ? l ? 1 /?/- e. This renuest void to ..,....mom r...... Ais request v.,d S// T 85383 L/CofB(? 13rt'arkR'(( 3s! 3o(og ?a,s6 ,'Request Date .? Fire No. Rough-ii Ins oeclion Reuu ned? ?Readv New 11 Notify , [ Wh Y es ? No en Ready or ad Licensed Electrical Contractor I hereby request inspection of above ? Owner electrical work. installed at: Street Address, Box or Route No. ?? /?c?lUmr??, ,??E. City c? A? ecvon u. lowaSruP Name or No. Rnnge No. '/ntt' (PRINT) Occu annt Phone No. ) Power Supplier Address a b C EI trlcal Contactor {LOmpeny Num.) Contractor's License No. >?l(AC73- Ma(Iln duress (C ontraumr or Owner Making Ins tailation) // A uthoriz tore IContr for ,Owner Makinq Installation) P ho Number / Q(?Q / MINNESOTA STATE BOARD Of ELECTRICITY - THIS INSPECTION REQUEST WILL NOT Griggs.Midway. Bldg. ^ Rgaa N-181 BE ACCEPTED BY THE STATE BOARD i e21 University Ave., St. Paul,'WN 551" UNLESS PROPER INSPECTION FEE IS pw....e fall »7_1111 ENCLOSED. ^REQUEST FOR ELECTRICAL INSPECTION Tt }(? (}( q See instructions for compleling form on back of ynllow cop V. "X"" Below Work Covered by This Request l: E8-0000111-03 Ne, Add Rep. ' hypo of Building Appliances Wiretl Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm r Vl? thcr Isuncifyl t tei specify r,r r Olher Compute Inspection Fee Below - ' N Fee Service Entrance Size p Fee Forders/Subfeed.r, 4 Fee Circuits I 0 to 100 Amps 0 to 30 Amps PTO 0 to 30 Amps 101 to 200 Amps 31 to 100 Amps 31 to 100 Amps Above 200 Amps Above 100Amps Above 100_Amps TranSternters Remote Control Circ. I Partial/Oth Signs Special Inspection g E T 7 5 Renunrks ?t { ?? ,?Q . OTAL F E , Rough-in L I 4. Data l1'(?/ 1 L- , ???? a Electrical Inspect hereby certify that the above Final t. ( Dnte LL f_ action has been r ?Q ??O made. This re ev1 void 18 months from This regoest void -7 X18 months from s--2.5 3Z 4 L )s, P/I 3cta?k (l 3'`d 3n10 g \/S2-Sb Roque Unto Fire No. Rough-in Inspection R oared? os ?No Ready Now WIII Notify Inspec- ? or When Ready Licensed Eleatncal Contractor I hereby request inspection of above Owner electrical work installed at: Street Address, Box or to No. Ci 9 &n eCUOn o. Township Nome or No. Rnnge No. County I or (PRINT) ( _^ Phone No. d l e- Pnwcr $uppli C44 (p Address EI ical Contractor (Cum Ay Name) _ ' Contractnr's.Licens'e No. Pi 0?{1LoO3-`? Mailing Add ss (Contractor or Owner Making Installati onl Authorized Signature ntracto nor Making Installation) Phone Numher 4 - 9 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Peat, MX 55104 UNLESS PROPER INSPECTION FEE IS ... 111111517-11111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION T Rv3 8 4 ? Soe instructions for completing form on back of VeI low copy. ow;tlObrk Covered by This Reqouuest w.er E13-00007-03 3vJo2? New Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating e Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm 0t n e the, (Speclly) Other ncci(y O(I 0thor Compute Inspection Fee Below P Fee Service Entrance Size rs a Fe Circuits C}.,? D to 10Am 5 3 r1 -10 0 to Am 101 to 200 Amps I ,? ._r 31 to 100 Am s Above 200 Amps = mps Above 100_Amts Trarufonner53 !. t. irc. ,$ Portia l.'Other i;gns fl \ r`" n $ / TOTA S ? Remarks / rr $3 L FE . 5 Rough-in Final ( ? Ua/te e (? l ?,'t `0 aJt, 15'k the Electrical Inspector, heraby certify that the above made ection has been This request void 18 months hpm