P - 84585�� II�I III II III �I III II III II II) II III II III I I�II ME°8 0� Sta° B a dEo ER�A�INSPE�ION ���
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* 0 3,� 5� g 2 5# 1821 University Ave., Rm. S-128, St. Paul, MN 55104 �
Phone (612) 642-0800 '�'-
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Re air
Air Cond. Htg. Equip. Water Htr: Load Mgmt. Other:
D er Ran e Elec. Heat Tem . Service
"k' above the work covered by this request. Enter remarks in this space and on the back of the whita copy ly.
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Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee:
Other Fee � $ervice Enfra $¢e Fee # Circvits/Feeders Fee
Mobile Home Park Stall 0 to ps $. o> 0 to 100 Amps . o
Street Ltg./Traffic Sig. Above 00 Amps Above 100 Amps
Transformer/Generator INSPECTOR'SUSEONLY TOTAL�
$ign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming Pool
�C`'.'�C�
I hereb ceAi that I ins ectad the elechical insfallafion described herein on the dahs stoted
Irrigation Boom Rough-In pa�
Special Insped
Final — pa�
Investigative F < -2`�_
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
315 —� 8 2 � OFflCE USE ONLY This request void 18 monMs from validafion dafe printed in this box '
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PLEASE PRINT OR TYPE
Request Dafe Rough-in inspeciion required2 � Yes No Inspection Other Than Rough-In: Ready Now � Will Call
5( (You must wll fhe inspedor when ready) Date Ready:
I, �}' licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (S}reef, Box, or Route No.) City Zip Code
5�1 <S�' . �Ve�, �idCE
Sedion No. Township Name or No. Range No. Fire No. Counly
a�
����P°^t Phone No.
S vE s�uN� 78'�- � y9's
Power $upplier Addr
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Elechicol Confracfor (Company Name) Confrador License No. Master lic. No. (Plant Eled. Only)
METTLER ELECTRIC CAO 1223 MO 2589
Mailing Addross (Confracfor or Owner Pehorming Insfollafion)
1240 46th Ave. N.E., Mpls., MN 55421
Authorized Signature (Conhatfor or Own rio ing i Ilafi q Phone No.
Mic 1 L M "��. �l" 574-9744
EB-OOOOlA-10 6/95 STATE BOARD COPY- SEE INSTRUCTIONS ON BACKOF YELLOW COPY