P - 83741. I II�III �III IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII M8 n� Uota SgatOe B e LR o SR 1C8, St PaPEMN ION04
* 0 3 6 3 2 6 3 5* Phone(612)642-0800
Home Duplex Apt. Bldg. Other: New
Commercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr. X Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above the work covered by this requesf. 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 p SO
Sign/Outline Ltg. Xfmr. 15. e@'
Alarm/Remote Control
Swimming Po ^'
I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boo Rough-In Date
X Speciallnspection 1 . 00
Final � D� � q �
Investigative Fee l
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
363-263�
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
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/S�Sd � JOB NUMBER #9706000
PLEASE PRINT OR TYPE
Requesl'�a1E 1'7 � C3'7 Rough-in inspection required? ❑ Yes �Jo Inspection Other Than Rough-In: [
� (You must call the inspector when ready) Date Ready:
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City
00510 57TH AVE NE FRIDLEY
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant
MICHAEL L
Power Supplier
Electrical Contractor (Company Name)
Mailing Address (Contractor or Owner Performing
Phone No.
CHEVRETTE
Address
IiPLS OFFICE
Contractor License No.
illation)
�1VAGE MN. 55378
Installation)
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LI
EB-OOOOtA-1 8/95 STATE BOARD COPY - SEE
Ready Now ❑ Will Call
7/17/97
Zip Code
55432
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N BACK OF YELLOW COPY
Master Lic. No. (Plant Elect. Only)
Phone No.