P - 83736- {If�lf�llllIIIIIIIIIIIIIIIIIIIIIIIIIIIiIIIIIIIIII
*03638889*
REQUEST FOR ELECTRICAL INSPECTION ��:�,
Minnesota State Board of Electricity �� �'
1821 University Ave., Rm. S-128, St. Paul, MN 55104
Phone (612) 642-0800 �-''�=�
Home Dupiex 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
"X" above the work covered by this request. Enter remarks in this space and on the back of the white copy only.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This Inspection Request will noi be accepted without the correcf fee:
Other Fee � Service Entrance Size Fee � Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
I Street Ltg./Traffic Sig. Above 200 Amps Above 100 Amps
ITransformer/Generator INSPECTOR'S USE ONLY TOTAL „SO
Sign/Outline Ltg. Xfmr. 15•���
Alarm/Remote Control - i
SWimming POO p I hereby certify that I inspected the electrical installation described herein on the dates stated I
Irrigation Boo - Ro�gn-i� Date I
I Special inspection •
Investigative Fee Final t�te U^ ��
,.]
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.
i 363-888 , �� �
�
�5'�� JOB NOMBER �i9706000
PLEASE PRINT OR TYPE
Request Rough-in inspection required? ❑ Yes o Inspection Other Than Rough-In: Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: %� 1%� 97
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
IJob Address (Street, Box, or Route NoJ City Zip Code
I 06250 7TH ST NE F'RIDLSY 55432
I Section No. Township Name or No. Range No. Fire No. County
ANOKA
IOccupant Phone No.
I SAHDRA !'[OSES 5'76-6011
Power Supplier Address
NSP ![PLS OPFICE
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)
12467 800NE AVE S. SAVAGE liN. 55378
` Authori d Signature ontract r ner Pe orming Instal�� � Phone No.
I � .�
, � r.'
� EB-OOOOtA-11 S/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY - �