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P - 84117IIIIIlIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII R8 (� UESe SFORve.LRm. SR1P8, St PaPEMNION04 �����> Minnesota State Board of Electricity '� * 0 3 7 1 6 5 7 8* Phone (612) 642-0800 �`'��� Home Duplex Apt. Bldg. Other: New Addn Commercial Industrial Farm Remod Repair 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 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 ONLV TOTAL Sign/Outline Ltg. Xfmr. 15. 50 Alarm/Remote Control Swimming Pool '� • I hereby certify that I inspected the electrical installation described herein on the dates stated Irrigation Boom Rough-In Date X Special Inspection 1. S0 Final Dat � �,`�� Investigative Fee ��------ �1� 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. 371-657 � � 5� � ���`T�� JOB HUMBER #9706000 PLEASE PRINT OR TYPE Requ�t��jEl'� � t�'7 Rough-in inspection required? ❑ Yes �lo Inspection Other Than Rough-In: [� Ready Now ❑ Will Call (You must call the inspector when ready) Date Ready: 10 � 1'7 � C�7 I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at: Job Address (Street, Box, or Route No.) City Zip Code @Q►238 69TH PL NE FRIDLEY 55432 Section No. Township Name or No. Range No. Fire No. County Occupant KEVIN A KELZENBERG Power Supplier Address NSP MPLS OE'FICE Electrical Contractor (Company Name) Contractor License No. MASTER ELECTRIC CO. IMC. CA0119. Mailing Address (Contractor or Owner Performing Installation) 1�467 B�ONE AVE 4�AVAGE MN SS'�78 AuthgrlAe¢�igqature (Contractor or Owner Performing Installation) ANOKA Phone No. 571-5057 8/95 STATE BOARD COPY - SEE INSTRUCTRiNS`�N BACK OF YELLOW COPY Master Lic. Na (Plant Elect. Only) Phone No.