P - 83474I REGIUEST FOR ELECTRICAL INSPECTION
� I���III) IIIII IIIII (IIII (IIII IIIII IIIII IIII IIII 1ng21eUn vess ty A earRmf SI 128 St. Paul, MN 55104
f * 0 3 7 8 9 1 0 4 i` Phone (612) 642-0800
Home Duplex Apt. Bldg. Other: New
Commercial Industrial Farm Remod
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 the back of the white cqoy only.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This Inspection Request will noi be accepted without the correct fee:
Other Fee � Service Entrance Size Fee � Circuits/Feeders
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200_Amps Above 100 Am
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Fee
Transformer/Generator INSPECTOR'S USE ONLY TOTAL
Sian/Outline Lta. Xfmr. 15. 50
Swimming Pool � � I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
X Speciallnspection 1 . 50
Final - Dat
Investigative Fee � Zg �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
� _---------------___------------__
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
378-91 � � �s�
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JOB HUMBER #�9706000
PLEASE PRINT OR TYPE
Reques��16 � 98 Rough-in inspection required? ❑ Yes �Jo Inspection Other Than Rough-In: (� Ready Now ❑ Will Call
(You must call the inspector when ready) �ate Ready: 6/ 1(� / C)8
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
00752 63RD AVE NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
RICHARD L PITTS
Power Supplier Address
NSP MPLS OF'FICE
Electrical Contractor (Company Name) Contractor License No.
MASTER ELECTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE KM. 55378
AyttTqriz„@d Signature (Contractor or Owner Performing Installation)
571-7111
EB-00001A�j/8/95 STATE BOARD COPY - SEE INS�iUt!"CIdNS ON BACK OF YELLOW COPY
Master Lic. No. (Plant Elect. Only)
Phone No.