P - 83727I�I�11i11IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIII MEQesota S atOe B aLd of EReCAL yNSPECTION �,���
1E21 University Ave., Rm. S-128, St. Paul, MN 55104 �._
�* 0 3 6 3 9 1 5 0* Phone (612) 642-0800 ''}'a<�� ��
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 ihis space and on the back of the white copy only.
SAVER'S SWITCH INSTALLATION
;ulate lnspection Fee - This lnspection Request will not be accepted wiihout ihe correct fee:
Other Fee # Service Entrance Size Fee �s 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
Transformer/Generator INSPECTOR'S USE ONLY TOTAL 3'�
Sign/Outline Ltg. Xfmr. 1S. e�•
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
Special inspection 1 . 00
Final p
Investigative Fee �__ _ � � ��Y
THIS INSTAL�arinN nnn E RDERED DI
363-915�
__ _ _ _ _ _ _ _ _ _ SCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
����
j,J'�� JOH NUMBER #9706000
PLEASE PRINT OR TYPE
RequesNgafE 1'7 � G�'� Rough-in inspection required? � Yes [�Jo Inspection Other Than Rough-In:
(You must call the inspector when ready) Date Ready:
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City
04762 2 1/2 ST NE FRIDLEY
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant
CHARLES L
Power Supplier
POPP
Address
Electrical Contractor (Company Name)
KAGT -R rTerr o , rNr
Mailing Address (Conhactor or Owner Performing Instailation)
12467 BO�N�' AV • S SAVA +�
Aut ized Si n ure (Con a r or Owner Performing Installation)
r "«
B-00001A-11 8/95 STATE BOARD COPY - SEE IN
Ready Now ❑ Will Call
7/17/97
Zip Code
55421
I Phone No.
572-8838
� OFFICE
Contractor License No. Master Lic. No. (Plant Elect. Only)
CA01147
Phone No.
� �
blil��B�CK OF YELLOW COPY
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