P - 83074I Illlil ��I� ��II) IIII� I�III II�I� IIII� IIIII IIII IIII Mg � Uoia SsaO Bo LR � SR1C8, St PaPEMN ION04 �����
r * * Phone (612) 642-0800 �"�'�"
03869872
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. ad Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above the work covered by this request. Enter rema�ks in this space and on the back ot the white copy only.
SAVER'S SWITCN IAISTALLATIOM
Caiculate inspection Fee - This inspection Repuest 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
Transformer/Generator INSPECTOR'S USE ONLY TOTAL
Sign/Outline Ltg. Xfmr. 1 S. �0
Alarm/Remote Control
Swimming Po '� I hereby certify that 1 inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
pecial Inspection, 15. 0 inal D te
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.
386-987� • �5;�
�7/�
JOB NUMBER �970600
P�EASE PRINT OR TYPE
Request Da� � 1�4 � 98 Rough-in inspection required? ❑ Yes ❑ Nox Inspection Other Than Rough-In: ❑ I�ady Now ❑ WII Call
(You must call the inspector when ready) Date Ready:
I, ❑�censed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code �
04631 2ND ST HE FRIDLEY 55421
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
SARAH J SINNINGER 571-6?09
Power Supplier Address
NSP MPI.S OFFICE
Elec[rical Contractor (Company Name) Contractor License No. Master Lic. No. (Piant Elect. Ony)
Mailing Address (Contractor or Owner Performing Installation)
Authorized Si ur (Contractor or Owner Performing Installation) `, �„�'�y ��� Phone No.
� L
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY