P - 83738I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 1n82�1�U�niverstyOAve.LRm. SR1C8,cStNP PEMNION04
� * * Phone(612)642-0800
03639671
Home Duplex Apt. Bldg. Other: New
Commercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr. j{ Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
I� "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
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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 Q
Sign/Outline Ltg. Xfmr. 15. e 0
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. 00 Final Date
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.
363-967� �,�g�
iSs�
JOH NUMBER �9706000
PLEASE PRINT OR TYPE
Request�� 1.' � 9.7 Rough-in inspection required? ❑ Yes ❑�Jo Inspection Other Than Rough-In: [� Ready Now ❑ Will Call
(YOU must call the inspector when ready) Date Ready:
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Sheet, Box, or Route No.) City Zip Code
01280 52ND AVE NE FRIDLEY 55421
Section No. Township Name or No. Range No. Fire No. County
Occupant
tiICHELLE M
Power Supplier
Address
ANOKA
Phone No.
c,7'1 �
Electrical Contractor (Company Name) Contractor License No. Master �ic. No. (Plant Elect. Only)
Mailing Address (Contractor or Owner Performing Insta lation)
Authori Signatur (Contractor or Owner Perfor ' I�allation) Phone No.
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EB-00001A-11 S/95 STATE BOARD COPY - SEE WSTRUCTIONS ON BACK OF YELLOW COPY I