P - 83592� I It�I) IIIIf III�I �IIII IIIII IIIII �IIII I�III III� IIII R8 QUESe SFORve.LRm. SR 1C8, StNPaPEMN'5O5N04 ����
Minnesota State Board of Electricity �
* 0 3 9 2 3 5 9 6* 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:
Dryer Range Elec. Heat emp. Service
"X" above the work covered by fhis request. Enter remarks in this space and on the back oi the white copy only.
SAVER'S SWITCH I1�5TALLATIDN
Calculate Inspection 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. �D. 50
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom aa,sn-i� Date
Special Inspect
Final D te ..._.i%!
Investigative Fee �S
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request wid 18 months from validation date printed in this box.
392-359 � � �5 , �
/a�
JOB HUMBER �9$06000
PLEASE PRINT OR TYPE
Reque�t Da� 30 / 98 Rough-in inspection required? ❑ Yes [�.yo Inspection Other Than Rough-In: p� Ready Now ❑ Will Call
1
� (Yai must call the inspector when ready) ji Date Ready: �S ����T�_
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Adtlress (Street, Box, or Route No.) City Zip Code
��200 ALDEN CIR NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. Counry
- AHOKA
Occupant php� Np.
ARTHUR C HOFF 571—
Power Supplier Address
Electrical Contractor (Comparry Name) I Contrac[or License No. Master Lic. No. (Plant Elect. Ony)
or
or
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY