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* 0 3 7 1 6 0 8 1 * Phone (612) 642-0800
Home Duplex Apt. Bldg. Other: New
Commercial Industrial Farm Remod
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 ot the white copy only.
SAVER'S SWITCH INSTALLATION
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Addn
Calculate Inspection Fee - This Inspection Request will not be accepted without the conect 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
Sign/Outline Ltg. Xfmr. 15. 50
Alarm/Remote Control
Swimming Poo a I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boo j �` Rougn-in Date
}{ Special Inspection 1 . S0
Final Date� . �
Investigative Fee v �' [�
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.
371-608 [� ���.� �
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JOB NUMBER #9706000
PLEASE PRINT OR TYPE
Requ�sGQa�1,7 � 97 Rough-in inspection required? ❑ Yes ❑�Jo Inspection Other Than Rough-In: [� Ready Now ❑ Will Call
1 YJ
(You must call the inspector when ready) Date Ready: � 0/ � 7/ q.7
I, ]�] licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
01661 75TH AVE NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. Counry
Occupant
MICHAEL C
Power Supplier
NSP
Electrical Contractor (Company Name)
AMBROSE
Address
MPLS OFFICE
Contractor License No.
Mailing Address (Contractor or Owner Performing Installation)
re (t;ontractor or (Jwner Performinp Instal
ANOKA
Phone No.
786-
I EB-00001lhU� 8/g5 STATE BOARD COPY - S�Ihj�R�'�'f��N BACK OF YELLOW COPY
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Master Lic. No. (Plant Elect. Only)
Phone