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P - 83076i��s�� i� �� ►� i�i�� *03869898* REGlUEST FOR ELECTRICAL INSPECTION �� Minnesota State Board of Electricity � �' 1821 University Ave., Rm. S-128, St. Paul, MN 55104 �.. . Phone (612) 642-0800 ��'�'��< Home Duplex Apt. Bidg. 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 requesf. Enter remarks in ihis space and on ihe back of the whiie cqoy only. SAVER'S S4VITCH INSTALLATION Calculate Inspection 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 Transformer/Generator INSPECTOR'S USE ONLY TOTAL Sign/Outline Ltg. Xfmr. 15. �0 Alarm/Remote ol $WIlIIllllll9 PO � I hereby certify tha[ I inspec[ed the electrical installation described herein on the dates stated Irrigation Boom Ro�9n-in Date peciallnspection � Final o Investigative Fee � --�—�1 THIS INSTALLATION MAY BE ORDERED CONNECTED IF NOT COMPLETED WITHIN 18 MONTHS. OFFICE USE ONLY This request void 18 months from validation date printed in this box. 386-989� • �s � S�� JOB NUMSER #� 7060� PLEASE PRINT OR TYPE Request Da,� � I 4 � gg Rough-in inspection required? ❑ Yes ❑ No}{ Inspection Other Than Rough-In: ❑ dy Now � Will Call (You must call the inspector when ready) Date Ready: 8I 1�i J S8 I, ❑�ensed contractor ❑ owner hereby request inspection of the above electrical work at: Job Address (Street, 8ox, or Raute No.) City Zip Code 04868 3RD ST NE FRIDLEY 55421 Section No. Township Name or No. Range No. Fire No. County ANOKA Occupant phone No. GEORGE G SPENCER 574-2283 Power Supplier Address NSP MPLS OF'F'ICE Electrical Contractor (Comparry Name) Contractor License No. Master Lic. No. (Plant Elect. Only) MASTER ELECTRIC C0. INC. CA01192 Mailing Address (Contractor or Owner Performing Installation) 1246'7 BOONE AVE S.SAVAGE liN. 55378 Au[horized Sign u (Contractor or Owner Performing Installation) (7 j�� PFwne No. V V � 9 - 7 / - EB-OOOOtA-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY