P - 83077,�I�I I�i I�I�� III�I I�II� �III� ��I�I �I��I �I��� ��I� I��I
*03869443*
REQUEST 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. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. oad Mgmt. Other:
Dryer Range Elec. Heat emp. Service
"X" above fhe work covered by this request. Enter remarks in this space and on the back ot fhe white copy only.
SAVER'S SWITCH 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 Control
Swimming Po I hereby certify that 1 inspected the electrical installation described herein on the dates stated
Irrigation Boo Rough-In �ate
pecial Inspection 1'rJ. 0 Fina� Date
Investigative Fee �-� �
THIS INSTALLATION MAY BE ORDERED DISC CTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months kom validation date printed in this box.
386-944� • /� �
5 ���
JOB NUMBER #970600
PLEASE PRINT OR TYPE
Request Dar� � 14 � 98 Rough-in inspection required? ❑ Yes ❑ Ndx Inspedion Other Than Rough-In: ❑ F�ady Now ❑ Will Call
(You must call the inspector when ready) Date Ready: a� 14I {38
I, ❑�icensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
04964 3RD ST NE FRIDLEY 55421
Section No. Township Name or No. Range No. Fre No. County
AHOKA
Occupant Phone No.
ERVIN A JOHNSON 572-8690
Power Supplier Address
NSP MPLS OFFICE
Electrical Contractor (Comparry Name) Contractor License No. Master Lic. No. (PI2nt Elect. Only)
lfASTER ELECTRIC CO. , INC. CA01I92
Mailing Address (Contractor or Owner Performing Installa[ion)
].2467 BOONE AVE B. SAVA E MN. 5 7
Authorized ' a e(Contractor or Owner Performing Installation) Phone No.
i �
E&00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY