P - 81392�I�11 III� III IIII' III I I IIIIIII M8 nOUolaSsatOeBoaLRm.SR1P8,cSt PaPEMNION04 ����.
* 0 3 9 2 3 6 5 3* Pnone 1si2J saz-osao ����+•-'
Home �uplex Apt Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. Load Mgmt Other:
Dryer Range Elec. Heat Temp. Service
" above [he work coveretl by this reques[ Enfei remarks in ihis space and wr the back ot the white copy only.
SAVER'S SWITCH INSTALLATFON
ulafe In�pection Fee - This Inspectiwr Request wil! not be accepted without the correct iee:
Other Fee s+ Service Entrance Sire Fee +� CircuitslFeeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Amps Above 100_Amps
TransformeNGenerator INSPECTOR'S I15E ONLV TOTA
Sign/Outline Ltg. Xfmr. �' `'�
Alarm/Remote Control
ihat I inspecletl tha elecMCal Inetellatlon tlesonbetl horaln on lhe datss stated
�ate
- ' Fina1 � � I e� �C�
Investigative Fee /
THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE IISE ONLV This reques� voitl 18 months fmm valitlation tlate pnMed in this bax.
392-36� 3 �/a��5 5�
JOB NUMBER #5�06000
PLEASE PRINT OR TVPE
Re4 Pough in Inspec�ion repuired? � Ves Inspection Other Than Rou9h-In'. Reatly Now p Will Call
�Vm must call the inspeclor when reatly) Oate Ready: 11 � 30% �a
I, �J licensed con[rector ❑ owner hereby request inspection of the a6ove electrical work at:
�ot�ar��s(�veet.eox,o��NO�T NE �itiIDLEY Z�P��432
orNO. IRa�geNO. IFIreNO. ICwnry ANOKA
Oxupant Phone No. �
FRAHK J KEELEY 571-2811
Power Suppller Htltlress
NSP MPLS DFFICE
Elechiml GonVactor (Compeny Name) Conhec[or Llwnse No_ Master Gc No. (Planl Elect Onry)
MASTER ELECTRIC CD.,INC. CA01192
Mailing Hddrsss (COn[rdc[or or Ownsr Periaming Instalbtion)
12467 BODNE AVE S.SAVAGE [�N. 55378
Authwizetl Signatu �. niractor or Owrer Per�ormirg Inslalla�bN Phone No.
26�� 941 4712/89Q�-3,`,�.
EB-00001A-i l 8/95 STATE BOARO COW - SEE INSTRUCTIONS ON 9AGK OF VELLOW COPY