P - 83081I IIIII��III �III) (IIII IIII� I�III IIIII (IIII IIII IIII
"� *03869658*
REQUEST FOR ELECTRICAL INSPECTION ��
Minnesota State Board of Electricity � °i_
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. oad Mgmt. Other:
Dryer Range Elec. Heat emp. Service
"X" above the work covered by fhis request. Enter remarks in this space and on the back of the white cqoy only.
SAVER'S SWITCH INSTALLATION
Ca�culate Inspection Fee - This Inspeciiar 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 ONLY TOTAL 1'-'J.�O
Sign/Outline Ltg. Xfmr.
Alarm/Remote ol
Swimming Poo �7 I hereby certify that 1 inspected the electrical installation described herein on the dates stated
rigation Boom ough-In Date
peciallnspection �
F'� Date
Investigative Fee C)'2�'
THIS INSTALLATION MAY BE ORDERED DISCONN CTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date priMed in this box.
386-965� ' S� �
JOB NUMBER #970600
PLEASE PRINT OR TYPE
Request Da Rough-in inspection required? ❑ Yes ❑ N Inspection Other Than Rough-In: ❑ ady Now 0 wll Call
(You must call the inspector when ready) Date Ready: 8� 14 / 98
I, ❑ licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job,a����,eaX,a�R��� ST NE °itjrFRIDLEY Z'P`�5421
Section No. Township Name or No. Range No. Fire No. County ANOKA
�cUP�'IANA K MUSKE P��eNO 574-0483
Power su lier Address
N�P IiPLS OFFICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Onry)
liASTER ELECTRIC CO. , INC. CA01192
Mailing Address (Contrac[or or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE MM. 55378
Authorized Signatyr� (�i6►i or or Owner Performing Installation) Phone No.
rr � � ' 94 —4712/890-355
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY