P - 83651. IIIIIjI�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII��lllllll R$ Q UESe SFORve.LRm. SR1C8, StNP PEMNION04 � ��
Minnesota State Board of Electricity �
* 0 3 6 3 2 4 7 8* Phone (612) 642-0800 �'��'�
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat emp. Service
X" above the work covered by this request Enter remarks in this space and on the back ot fhe white copy only.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This Inspection Requesf will not be accepted without the correci tee:
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 ,. Q
Sign/Outline Ltg. Xfmr. 1S.
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 Ins ' n . (�0 , ` �
Final �
Investigativ
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 363-247� - � � � 3 ��
�'" �J� JOB NUMBER #�9706000
PLEASE PRINT OR TYPE
Request9afC 1'7 � i3^f Rough-in inspection required? ❑ Yes �{Jo Inspection Other Than Rough-In:
(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
06231 ALDEN WAY NE FRIDLEY
Section No. Township Name or No. Range No. Fire No. County
Occupant
GLENN D
Power Supplier
Electrical Contractor (Company Name)
Ready Now ❑ Will Call
7/17/97
Zip Code
55432
AHOKA
Phone No.
BOTTOliL.Y 572 -3795
Address
Contractor License No. I Master Lic. No. (Plant Elect. Only)
Mailing Address (Contractor or Owner Performing Installation) .
Author d Sig at re (Con r or Owner Performing Installation) Phone No.
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY