P - 83740I IIIIII�I�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 1n82�1 U�iverst0 Be R� SRIC8LSt PauPIEMN 5O5N04 ����
* 0 3 6 3 9 2 4 2'r Phone (612) 642-0800 '�-`'�''�
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above the work covered by this request. Enter remarks in this space and on ihe back of the white copy only.
SAVER'S SWITCH INSTALLATION
Calculate lnspection Fee - This Inspection Request will not be accepted without the correct tee:
I 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 TOTA
Sign/Outline Ltg. Xfmr. �5'$�
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
Speciallnspection � Final
Datg �
Investigative Fee ;���_, ,6 Z, — f �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
�_��� `�T�^M� y"'OFFICE USE ONIY This request void� 18 months from validation date printed in this box.
363-924�]
��� �
�5,�� JOB NUMBER #�9706000 �
PLEASE PRINT OR TYPE 'i
� Request Rough-in inspection required? ❑ Yes o Inspection Other Than Rough-In: Ready Now ❑ Will Call I�
� (You must call the inspector when ready) Date Ready: %� 1%� 9%
I, jJ licensed contractor ❑ owner hereby request inspection of the above electrical work at:
J�0050�Sreet, Box, o54TH � AVE NF. F�ilIDLEY Z�P55421
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
BARBARA AHN REILAND 592-0391
Power Supplier Address
NSP IiPLS OF'FICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
liASTER ELECTRIC CO. , INC. CA01192 I
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE KN. 55378
Authori Signature ontract o Owner Performing Instal�jjpr�. '' Phone No.
� "
'��' � � .� 941 4712/890-3555
� EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
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