P - 81388���IIIIIIIIII III IIIIII III II II
REQUEST FOR ELECTRICAL INSPECTION �,���,�,..
Minnesota State Board of Electricity g
1821 Unlversity Ave., Rm. S-128, St. Paul, MN 55104 ����`"
" 0 3 9 2 3 5 5 4* rnone tn�z� anz-uaw •-�_
Home Dupiex 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
"%" above the work covered by this requesG Enier remarks in [hi5 space and on the back o/ Ihe white copy wrly.
SAVEk'S SWITCH INSTALLATION
Calculate �nspection Fee - This Inspec[ion Reques[ will not be accepted withoui the conect /ee:
Other Fee � Service Entrance Size Fee x Circuils/Feetlers Fee
Mbbile Home Park Siall O to 200 Amps 0 to �00 Amps
Street Lig./Traffic Si9. Above 200_Amps Above 100_Amps
TransformeNGenerator WSPECTOR'SUSEONLY TOTA4� 50
Sign/Outline Ltg. Xfmr. f'
Alarm/Remote o rol
SwimmingPo ' ihefee Fe
y certify ihal I Ics cletl tM1e elec�Iical Installa�ion desaibed herelr on iM1e tlatas stat�d
Irrigation Boom � aouqn-in �ate
Special Inspection c
F�„ai /^ � o -f %
Investigative Fee ` /—b o 3L— 2z
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE U56 ONLY Thisrpquest witl 18 rtronihs irom valitla[ion Ce�e printstl in ihis boz.
392-35�] � �a� 5. �
JOH NUMBER #9$06000
PLEASE PRINT OR TYPE
Repuo RWgh-in Inspection requlretl? � Yes ❑ o InspeGion Olher Than Rough-Irt Ready Now p WII Cell
�vo� m� �au me ���soe�ro, wne� read» oat� aeeoy�. 1 1/ 30 / 98
I. [] licensed wntractor ❑ owner hereby request inspection of the above electrical work at'.
�e���s�i�,ee,.m..��i��1N��T NE ��?IDLEY Z°��5�432
Section No. Township Name or No. Ranga Nn Fi�e No. Gourry
ANOKA
MARTHA FUENTES P��� 571-6750
Powe, s�oo��e, naareas
NSP MPLS 6FF'ICE
Eleclrical Conhactor (COmparry Nrenel GonVador Licensz No. Mes�er Lic. No. fPlant Elect Only�
MASTER ELECTRiC CO.,iNC. CA01192
MaiG�y A�tl�ess (COnVactor or �wrer P=rformir , Installaticn)
12467 BOOME AVE S.SAVAGE MN. 55378
Aulhorizetl SiqnaNre ICO tor or Owncr Periorming Installation) 1�,!7 Phone No.
� 941 4712/850-3555
E&Op001A-i l 8/95 STATE BOAHO GOPY - SEE INSTROGTIONS ON 9PGK OF YELLOW COPV