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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 copy only.
SAVER'S SWITCH INSTALLATION
ulate Inspection Fee - This Inspection Request will noi 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 o
Sign/Outline Ltg. Xfmr. 15.��
Alarm/Remote Control
Swimming P I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Bo Rough-In Date
. . Final � . �Q . I D/ Z ^ Z ��GS
Investigative Fee �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
--------------�--^----
� OFFICE USE ONLY This request void 1S months from validation date printed in this box.
363-274� `� ,�� � �� �
JOB NUMBER �9706000
PLEASE PRINT OR TYPE
Request-�aj� 1 f/`.l' / Rough-in inspection required? ❑ Yes ❑T►lo 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
06041 6TH �T NE F�tIDLEY
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
JAltES H EHL.ERT
Power Supplier Address
NSP MPLS OFF'ICE
Electrical Contractor (Company Name) Contractor License No.
MASTER ELECTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
1246'7 BOONE AVE S. SAVAGE MN. 55378
Autho � Signaty� (Contr flr o,r�� Performing Installation)
_/ /_ . _ �l/ '�l n � ,� .� n .....
Ready Now ❑ Will Call
7/17/97
zip��432
571-3670
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELIOW COPY
Master Lic. No. (Plant Elect. Only)
Phone No.