P - 83737REQUEST FOR ELECTRICAL INSPECTION �
� I I��II�IIII IIIII (�III IIIII IIIII IIIII IIIII IIII IIII 1n821eUn vess ty A earRmf SI 128cSt. Paul, MN 55104 �_��
* 0 3 6 3 9 4 5 7* Phone (612) 642-0800 ����
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. X 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 white copy only.
SAVER'S SWITCH INSTALLATION
:ulate Inspection Fee - This lnspection 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 i$' p
Sign/Outline Ltg. Xfmr. 15. �
Alarm/Remote Control
Swimming Po I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
Speciallnspection 1
Final D
Investigative Fee �. � —
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.
363-945� �
���Q � ��� B HUtlHER #�9706000
PLEASE PRINT OR TYPE
Request�a� 17 � 97 Rough-in inspection required? ❑ Yes �lo Inspection Other Than Rough-In: [X Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: 7� 17 � 97
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
00249 49TH AVE NE FRIDLEY 55421
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant
ARNE
Power Supplier
NSP
Electrical Contractor (Company Name)
Mailing Address (Contractor or Owner Performing
SIKENGAARD
Address
Contractor License No.
Phone No.
572-8815
Master Lic. No. (Plant Elect. Only)
Signa r(Contr t Owner rforming I�y I n) Phone No.
� � �G�� � j cadt 712
1A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY