P - 83559IIIII) ���� IIIII IIII! IIIII lllll IIII1 III�I IIII flll 1n82�1 U�nivers tO Ave.LRm SR1C8 StNP PEMN ION04 ����
Y
`* 0 3 9 2 3 2 6 5�` Phone (612) 642-0800 � � ���%�
Home Duplex Apt. B{dg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. � Load Mgmt. Other:
Dryer Range Elec. Heat emp. Service
"X" above the work covered by this request. Ente� remarks in this space and on ihe back of the white copy only.
�;AVER'S SWITCH INSTALLAT30N
Calculate lnspection Fee - This Inspection Request will not be accepted without the coirect 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
SignlOutline Ltg. Xfmr. . 5Q►
Alarm/Remote Control
Swimming Pool I hereby certify that I inspec[ed the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
}{ Speciallnspection 1 � (a , �
Flnal D e
Investigative F � �S—
THIS INSTALLATION MAY E ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONI.Y This request void 18 months from validation date printed in this box.
392-32C�5] ���, I S•�
�
JOB NUMBER #9�06000
PLEASE PRINT OR TYPE
Requa6t Date�O j 98 Rough-in inspection required? � Yes �lo Inspedan Other Than Rough-In: [� Ready Now ❑ Will Call
11/
(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 Zip Code
06035 2ND ST NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. Gounty
AxoxA
Occupant Phone No.
KEVIM D�RRICK AHI.ERS 571-2?29
Power Supplier Address
NSP MPLS OFFICE
Electrical Contractor (Company Name) � Contractor License No. Master Lic. No. (Plant Elect. Only)
MASTER ELECTRIC CO. IHC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
Authorized Signature (Contractor or Owner Pertorming Installajlqp) ^ tf. � � Phone No.
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EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YEL�OW COPY