P - 84099III����IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Mg �juoia SstyOAve.LRm. SR1C8, St PaPEMNION04 ��������
� * * Phone (612) 642-0800 °�`��?"
03716867
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above the work covered by this request. Enter remarks in this space and on the back of the white copy only.
SAVER'S SWITCH INSTALLATION
Calculate /nspection Fee - This Inspection Request will not be accepted without the correct fee:
Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Amps Above 100 Amps I
Transformer/Generator INSPECTOR'S USE ONLY TOTAL I
Sign/Outline Ltg. Xfmr. 15. `�J0
Alarm/Remote Control
Swimmrng Po ' � `
I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rougn-in Date
Special Inspection
Final
Investigative Fee � —
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
371-686 7� l5�
,���y���
JOB NUMHER �97Ql6000
PLEASE PRINT OR TYPE
Reque�t�a�e17 � 9+7 Rough-in inspection required? ❑ Yes �Jo Inspection Other Than Rough-In: [� Ready Now ❑ Will Call
(YOU must call the inspector when ready) Date Ready: 1�� 17 � 97 �i
I, u licensed contractor ❑ owner hereby request inspection of the above electrical work at: II
Job Address (Street, Box, or Route No.) City Zip Code
04507 2 1/2 ST NE FRIDLEY 55421
Section No. Township Name or No. Range No. Fire No. County I
axoxA I
Occupant Phone No.
APiY I ROGERS 571-5079
Power Supplier Address
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
MASTER ELECTRIC C17. , INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
Authori ig ture (Contractor or Owner Perforrr�ng In�stallation) Phone No.
�ic�' j �` �
B-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY