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*03798493*
REQUEST FOR ELECTRICAL INSPECTION ��
Minnesota State Board of Electricity � �
1821 University Ave., Rm. S-128, St. Paul, MN 55104 ,,�
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 emp. Service
"X" above the work covered by this request Enier remarks in this space and on the back of the white copy only.
SAVER'S SWITCH IHSTALLATION
Calculaie 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 1 S.
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming P I hereby certiy that I inspected the electrical installation described herein on the dates stated
rigation Boom -m Date
peciallnspection • Final C
Investigative Fee � "-7 '� %�
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
QFFICE USE ONLY This request void 18 months from validation date printed in this box.
379-849� � � �
l�- ,�.� �3i�
JOB NUMHER #970600
PLEASE R T O TYPE
Request Da Rough-in inspection required? ❑ Yes ❑ N Inspection Other Than Rough-In: ❑ ady Now ❑ Will Call
� (You must call the inspector when ready) Date Ready: 6/ 19 / 98
I, ❑ licensed contractor ❑ owner hereby request inspection of the above electrical work at:
�ob /����x�t, Box, or Ro�t�r,�,lf,j A V E NE c'tYFR I DLEY Z'p °0�5432
Section No. Township Name or No. Range No. Fire No. County ANOKA
°oai�tARLYN F JESKE Pn°"e"° 786-7129
Powe����p�r Address �PLS OF F ICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
ltASTER ELECTRIC CO. , INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
1246? BOONE AVE S. SAVAGE IiN. 55378
Authorized Signature ff.ontractor or Owner Performing Install@iiQny.� � O� Phone No.
vti iG V 94 —4712/890-355
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY