P - 83743; III�II��IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII M8 QUoja StatOe B aLd of EReCALyNSPECTION �''���.,
s ty Ave., Rm. S-128, St. Paul, MN 55104 �
* 0 3 6 3 2 5 3 6* Phone(612)642-0800 �»,�s`
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 rema�ks in this space and on the back of the white cqoy only.
SAVER'S SWITCH INSTALLATION
�ulate Inspection Fee - This lnspection Request will not be accepted without the coirect 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 ONLV TOTAL r
Sign/Outline Ltg. Xfmr. 15.
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom w Rough-In
Date
Speciallnspection .0
Investigative Fee Final pa �^ F
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS. G
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-253�]] �,5�3�6i
��'�v JOH NUMBER �9706000
PLEASE PRINT OR TYPE
Request'QajQ 1'7 � C3'� Rough-in inspection required? ❑ Yes �lo 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
00690 59TH AVE NE FRIDLEY
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant
HAROLD BREZNY
Power Supplier Address
NSP Kp
Electrical Contractor (Company Name)
Mailing Address (Contractor or Owner Performing
Owner Performing Installation)
Ready Now ❑ Will Call
7/17J97
Zip Code
55432
Phone No.
571-3806
I.S OFPICE
Contractor License No. Master Lic. No. (Plant Elect. Only)
Phone No.
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1A-71 �$/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY