P - 83747i
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* 0 3 6 3 2 4 6 0* Phone(612)642-0800
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. X 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 lnspection 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 c S�
Sign/Outline Ltg. Xfmr. i5. �
Alarm/Remote Control
Swimming Poo '`
I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
}{ Speciallnspection 1 . 00
, Final ���� Date
Investigative Fee � _ .___..,�� � � __ � ��
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
e-- — ----------_------
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-246 �f �
���$� � � JOB HUMHER �9706000
PLEASE PRINT OR TYPE
rtequesr�sa)e 1-� � y-� Rough-in inspection required? ❑ Yes ❑�Jo Inspection Other Than Rough-In: [,( Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: %� 17�97
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
00105 75TH WAY NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
![ICHAEL W BORN 574-0801
Power Supplier Address
NSP MPLS OFFICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
MASTER ELECTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
S. S VA ![N. 55378
Author Signatur (Contra Owner Performing Installal%�)� ` [1 r— - Phone No.
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EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY