P - 83560I IIIII�'ll�� I�I�I II�I) I�III �II�) �III� IIIII III) IIII 1n82�1 U�iverstyO Ave.LRm. SR 128, StNP PEMN ION04 ����,,,��;
� * * Phone (612) 642-0800 '�"�' �'
03923430
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr, X Load Mgmt. Other:
Dryer Range Elec. Heat emp. Service
X" above the work covered by this request. Enter remarks in this space and on ihe back of the white copy only.
SAVEk'S SWITCH INSTALLATIOH
Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee:
Other Fee # Service Entrance Size Fee # Circuits/Feeders
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Amps Above 100 Am
Transformer/Generator INSPECTOR'S USE ONLY TOTAI
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
S ' P I
Fee
r,
wimming 00 I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-in Date
X Speciallnspecti C
Final D
Investigative Fe t — !
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
, ._,.. -��.-_____�____._��
OFFICE'(l,F pNLV This request vcifd 18 months from validation date printed in this box.
392-34�J] `�� 1 �
JOB NUMBER #9�Jf06000
PLEASE PRINT OR TYPE
Reque�t �at� 30 � 98 Rough-in inspection required? ❑ Yes �o Inspec[ion O[her Than Rough-In: j� Ready Now ❑ Will Call
(You must call the inspectw when ready) Date Ready. 11 / 30 / 98
I, �j licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
06151 6TH ST NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant
STEVE P
Power Supplier
Electrical Contractor (Company Name)
Mailirg Address (Contractor or Owner Performing
Phone No.
DEGROTE
Address
liPLS OFF'ICE
Contractor License No.
Authorized Signature (Contractor or Owner Performing Installatan) '
571-6082
EB-00001A-11 8/95 ' STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
Master Lic. No. (Plant Elect. Only)
Phone No.