P - 83466,I �fI��I �III IIII) IIIII IIIII IIIII IIIII IIIII llll llll M$ Q Uoia StatOe B aLd of EReCAL YNSPECTION �,. •,•�a�.... �
e s ty Ave., Rm. S 128, St. Paul, MN 55104 � �
* 0 3 7 8 9 y 6 1 * Phone (612) 642-0800 ��--= e
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. }C 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 whiie cqoy only.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This lnspeciion Request will not be accepied 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. lrj. �'j0
Alarm/Remote Control
SW� � I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation O Rough-In Date
}{ Speciallnspection 1 . 50
Final
Investigative Fee _2
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ON�Y This request void 18 months from validation date printed in this box.
378-916�] � �
��
JOB NUMBER #�9706000
PLEASE PRINT OR TYPE
Request�ay�16 � 9$ Rough-in inspection required? ❑ Yes o Ins ection Other Than Rou h-In: Read Now
� p 9 � y ❑ Will Call
(You must call the inspector when ready) Date Ready: �j � 6/ 98
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
05816 2ND ST NE #2 FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant
Phone No.
EUGENE ROGER TOMAS 574-2306
Power Supplier Address
NSP MPLS OFE'ICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
MA�TER EL.ECTRIC C0. , INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE MN. 55378
tho ' ed S� nature (Contractor or Owner Performing Installatior� A Phone No.
'' ",�5
EB-00001A-11 /95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY