P - 83015IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIII) R82�1 UEiSersFORve.LRm. SRIC8 St PaPEnC�lON04 ����
Minnesota State Board of Electnaty �
� * 0 3 7 9 8 0 5 5* Phone (612) 642-0800 ���-�
Home Duplex Apt. Bldg. Other: S� New Addn
Commercial Industrial Farm ��� Remod Repair
Air Cond. Htg. Equip. Water Htr. oad Mgmt. Other:
Dryer Range E{ec. Heat Temp. Service
"X" above the work covered by this request. Enter remarks in this space and on the back of the white copy only.
SAVER'S SWITCH INSTALLATIOPI
Calculate Inspection Fee - This Inspection Request will not be accepted withoui 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 15. {�0
Sign/Outline Ltg. Xfmr.
Alarm/Remote I
Swimming Pool � I hereby certify [hat I inspected the electrical installation described herein on the dates stated
Irrigation Boom Ro�9n-io Date
peciallnspection '
Final Dat
Investigative Fee -'L—�
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.
37s-so� � �a �
1
/),���/9 JOB HUMBER #970600
PLEASE PRWT OR TYPE �C
Request Da Rough-in inspection required? ❑ Yes ❑ N Inspection Other Than Rough-In: � ady Now ❑ Will Call
(You must cail the inspector when ready) Date Ready: f3 � 19 � 98
I, ❑ icensed contractor ❑ owner hereby request inspection of the above electrical work at:
,�ob n�����et, Box, or R��� ST NE c�tvFR I DLEY Z�P ��5421
Section No. Township Name or No. Range No. Fire No. ��� ANOKA
�`wPIKtICHELLE J BITZER PhoneNo. .7$1—•7410
Power Supplier Address
NSP [iPC.S OF'FICE
Electrical Contractor (Comparry Narne) Contractor License No. Master Lic. No. (Plant Elect. Ony)
1'iASTER ELECTRIC CO. , INC. CA01192
Mailing Address (CoMractor or Owner Performing Installation)
12467 BOOME AVE S. SAVAGE MN. 55378
Authorized Si (Contractor or Owner Performing Install ���� Phone No.
94 —4712/890-355
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY