P - 81402Il�llllllllll Illllllllllllllll III IIII IIIIIII M8 n� Uoia SFO �a R�cTR,CBIStNS PEMNION04 ����,;
� * 0 3 9 2 3 4 9 7* Pno�e�siz>s42-oaoo ����
Home Duplex Apt. Bldg. Other�. New Addn
Commercial Industrial Farm Rempd Repair
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other.
Dryer Range Elec. Heat emp. Service
"X" above !he work covered by this request. En[er iemarks in this space and on the back ot fhe white copy onN�
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This In.qnection Reques! will not be accepfed without the coirect fee:
Other Fee < SefVice Entrance Sire Fee < CirCUits/Feetlers Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street LiglTraffic Sig. Above 200_Amps Above 100_Amps
TransformeNGenerator �NSPECTOfl'SUSEONLV � TOTAI��. 5�
Sign/Outline Ltg. Xfmr. j
Alarm/Remote Conirol
Swimming Po I hereby cetlify ihat I Inspeo[atl IDe alecVical lnstallatlon described herein on �ha de�es stetatl
Irrigation Boo } ao�qn-i� oaie
Speciallnspeciion. �
Fnel Dale
Investigative Fee � — � �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETE� WITHIN 18 MONTHS.
OFFICE USE ONLV This reques[ wid 18 mon�hs imn valydatior tla�e printed In this box.
392-349� ��6�5 �j
JOB NUMSER �15i�060�d0
PLEASE PRINT OR TYPE
Reque Rough-in irspection mqutred7 0 Yas ❑ o Inspection Other Than Rou h-In: qeatl Now
9 y ❑ WIIICaII
11'ou mus[ call the inspectar whon reetly) Date Raetly: 1 1� 3(� � 9�4
I, � Ilcensed contractor ❑ owner hereby request inspection of Ihe above electrical work at:
Job Address (Sheet Boz, or Route N] Zlp Code
01465 66T1� AVE NE ��?IDLfiY 5`�432
Section No. Township Name or No. Rarge No. Fi�e No. Cwnty
ANOKA
Occu0anl Phone No.
HERBERT L EGENIESS 571-2001
Power Suppller Address
NSP MPLS DFFICE
E'ectrical Contractor (Comparry Name) Contraclor License No_ Master Ge. Na (Plant Eleot Only)
MASTER ELECTRIC CO.,ING. CA01192
Malirg Atldress (COntractororOwnerPerlorminglnetalla�ion)
12467 BOON£ AVE S.SAVAGE MN. 55378
ANhorized Signature (GOntraotor or Owner Perfortning Insiellapon) Phone No.
541 4712/850-3�'�S�
EB-00001A-11 8.�95 STATE BOARD COPV - SEE MSTRUCTIONS N ACK OF VELLOW COPY