P - 83024� �IIII�I IIIII �I�II IIIII (IIII �I�II IIIII IIIII llll (�II Mg Q Uoia SsaO B aLR � SR 1C8,CSt PaPEMN ION04 ����
* 0 3 8 Q 4 3 Q 9* Phone (612) 642-0800 �"��
Home Duplex Apt. Bldg. Other: -, New Addn
Commercial Industrial Farm � d -j� Remod Repair
Air Cond. Htg. Equip. Water Htr. }( Load Mgmt. Other:
Dryer Range Elec. Heat emp. Service
"X" above the work covered by this �equest. Enter remarks in this space and on the back of the white copy only.
SAVER'S SWITCH INSTALLATIUN
Calculate Inspection Fee - This �nspection Request will not be accepted without the Correct fee:
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 TOTAL /s", „$'D
Sign/Outline Ltg. Xfmr. �6r 3@
""""""""y '"`N I hereby certify thai I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
}{ Special Inspection 1 . 50
Final
Investigative Fee �.^ 3 —
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONIY This request vad 18 moMhs from validation daie printed in this box.
3so-43o
. ,�,� ,����� •
JOB NUMBER #k9706000
PLEASE PRINT OR TYPE
Req�st B�t� 07�, g8 � qough-in inspection required? ❑ Yes ❑ xo inspection Other Than Rough-In: [�Ready Now ❑ Will Call
(Ybu must call the inspecta when ready) Date Ready: '7 � 07 � 98
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
00720 67TH AVE NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
.TAMES A KOSSE 571-5165
Rower Supplier Address
MSF IiPLS OFFICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Ony)
MASTER EI.ECTRIC CO. INC. CA01192
Mailing Address (CoMractor or Owner Performing Ins[allation)
Authorized i (Contractor or Owner Performing Installation) Phor�e No.
EB-OOOOtA-11 S/95 � STATE BOARD COPY - SEE INSTRUCTIONS N BA OF YELLOW COPY