P - 83033REQUEST FOR ELECTRICAL INSPECTION
6�.� ���/� � Minnesota State Board of Electricity
�-f 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 Re air
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.
Install 100 Amp Service. �
Calculate Inspection Fee - This Inspection Request will noi be accepted without the correct fee:
Other Fee # Serv' e Entranc 'ze Fee # Circuits/Feeders Fee
Mobile Home Park Stall j 0 to 00 Amps 25 .00 0 ro 100 Amps
Sheet Ltg./Traffic Sig. Above 200 Am s Above 100 Amps
Transformer/Generator INSPECTOR°S usE oN�v TOTAL . 50
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming Pool
I hereb certi Ihat 1 ins fed the elechical installation de.scribed herein on the dates stafed
�ffi9UhOf1 �00 RougMn Dofe
Special lnspec'
Investigative Fee F��� �,��
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This �equest void 18 monfhs from validation date printed in this box.
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PLEASE PRINT OR TYPE
Requesf Date Rou fFin ins on r uired?
8/20/98 9 P�h eq ❑ Yes � No Inspecfion Other Than RougMn: ❑ Ready Now � Will Call
�You must call the inspector when reody) Date Ready:
I, Qlicensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Addreu �Sheet, Box, or Route No.) City Zip Code
6445 Able Street NE Fridley
Section No. Township Name or No. Range No. Fire No. County
Anok8
Occupant Phone No.
Renee Burman
Power Supplier . Address
NSP
Elechical Conhacfor (Company Name� Contracfor License No. Master Lic. No. �Planf ElecF. Only)
FRONTIER ffi.ECTRIC COMPANY CA00701
Mailing Address (ConkoMor w Owner Performing Installafion) '�
800 Water Street Fxcels'or lyN 55331
Aufhorized Si a �Conkaclor or Qwner Perfo Insfal ' � Ph ne No.
� � �p/�� 474-3201
E&000 1 A-11 8/96 STATE BOARD COPY - SEE INSTRUCTIONS UN BACK OF YELLOW COPY