P - 8279566� ��87 �
X Home Duplex
Commercial Industrial
Air Cond Htg. Equ
Dryer Range
"X" above ihe work covered 6
RE(�UEST FOR ELECTRICAL INSPECTION
Minnesota State Board of Electricity
1821 University Ave., Rm. S-128, St. Paul, MN 55104 �
Phone(612)642-0800 "�'
Othec New Addn
farm
Water Htr. Load Mgmt. Other:
Elec. Heat Temp. Service
request. Enter remarks in this space and on the
Calculate Inspec►ion Fee - This Inspection Request will not be accepied without the correct fee:
Other Fee # Service Entrance Size Fee # Circuits
Mobile Home Park Stall 0 to 200 Amps 0 to 100 A
Sireet Ltg./Traffic Sig. Above 200 Am s Above l Od
Transformer/Generator INSPECTOR'S USE ONLY
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming Pool
Irriaation Boom
I herebvi cerlifv that I insoected the electrical
copy
dares srated
Fee
Investigative Fee - `� � - - `"� —"L
THIS INSTALLATION MAY BE OR�RED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This requesf void 18 monfhs from wlidation date prinTed in this box.
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* 0 6 6 8 8 8 7 3* ����
PLEASE PRIFIT OR TYPE
Requesf Dafe Rough-in inspeclion required? ❑ Yes � No Inspection Other Than Rough-In: � Ready Now ❑ Will Call
7�29-98 �You must coll fhe inspec�or when ready) Date Ready:
I, [�licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Sheef, Box, or Route No.) Ciy Zip Code
7374 Able St NE FRidley 55432
$ection No. Townshio Name or No. Ranae No. Fire No. Counw
Occupant
John Heffken
Phone No.
784-6843
tleckical Confracfor (Company Name) Conhocfor License No. Master Lic. No. �Planf Elecf
Total Electric Inc. CA02749
Mailing Address (Conhacror or Owner Performing Installation)
1537 92nd Ln NE Blaine MN 55449 .�-
Aufhorized nature �Contractor or Owner Pe ing Insfallafion) Phone No.
786-8484
EB-0 A-11 8/96 S7A� gOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY