P - 83744I % II�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII R8 � UESe SFORve.LRm. SRiCB SINP PEMNIONo4 �������
Minnesota State Board of Electricity �
*03632999*
Phone (612) 642-0800 ��"�`""
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
above the work covered by this request. Enter remarks in this space and on the back of the white copy only.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This Inspection Request will not be accepted without fhe correct tee:
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 ONLY TOTA15. O
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming Poo I hereby certify that I inspected the electrical installation described herein on the dates stated
Irriaation Boom � Ro�9n-in Date
Special Inspection 1• 1°r' oa �. Z�. �
Final
Investigative Fee �
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.
363-299� .���8d �
`�"� G JOB NUMHER �9706000
PLEASE PRINT OR TYPE
Request fdaj� 1//`j / Rough-in inspection required? ❑ Yes ❑iLlo Inspection Other Than Rough-In: [
(You must call the inspector when ready) Date Ready:
I, u licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) Cit
00881 66TH AVE HE F�tIDLEY
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
ltICHAEL J [3USTAFSON
Power Supplier Address
HSP ![PLS OFF'ICE
Electrical Contractor (Company Name) Contractor License No.
ltASTER ELECTRIC CO. INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE MN. 55378
Authoriz,�d�Signat�re (�ontractoh oyJOw r P ming Installation)
Ready Now ❑ Will Call
7/17/97
Zip Code
55432
571-3948
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
Master Lic. No. (Plant Elect. Only)
Phone No.
0