P - 83561IilI�I�11��II1I�lllllll�llll�l�lllll�lll�l�l�l�l�l Mg QUEa SstyOAve.LRm. SR1C8, StNP PEMNION04 � ���
* 0 3 9 2 3 2 9 9* 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:
Dr.yer 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 onty.
SAVEF!'S SWITCH INSTALLATION
Calculate lnspection Fee - This Inspection 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
Sign/Outline Ltg. Xfmr. � 5
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
Special Inspecti
Final te. /^
Investigative Fe �� � j�
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.
392-32�9] � �'�� t 5��,
JOB HUMBER #��06000
PLEASE PRINT OR TYPE
Req i ia% 30 / 98 Rough-in inspection required? ❑ Yes aplo Inspection Other Than Rough-In: Q� Ready Now ❑ Will Call
1t X
(You must call the inspector when ready) Date Ready:
I, �] licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
06160 7TH ST NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
Power Supplier Address
ElecVical Contractor (Comparn� Name) Contractm License No. Master Lic. No. (Plant Elect. Ony)
Mai mg nt c r r ne ami g nsiaAati n �
Au e i aW or n Pe r?n s I i I� �, � � phone No.
:�
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY