P - 81150REQUEST FOR ELECTRICAL INSPECTION "�^ '�
O_8C�8'294 � Minnesota State Board of Electricity -
v 1821 Universiry Avenue Suite S-128, Saint Paul, Minneso[a 55704-2993
� (651) 642-0800 www.elecfricity.state.mn.us
Home Duplex Apt. Bldg. Other: New Atldn
Commercial industriai farm Remod Repair
Air Conditioner Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elect. 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.
A1SP SAVER'3 3WITCH
Calculate lnspection Fee - This Insnection Reauest will nof be acceafed without the correct tee.
Mobile Home Park Stall
Street Ltg. / Traffic Sig.
Transformer/Generator
Sign / Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming Pool
Irrigation Soom
0 to 200 Amps 0 to 100 Amps
Above 200 Amps Above 100 Amps
INSPECTOR'S USE ONLY TO�,(.�
Rough In
that I insoected the electrical installation describetl herein on ihe dates stated:
F.w �C Datr•t,— o_ C3G
Investigative_ ee � ..1 l
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
�,w��M~����M�TM�u�»�M T�TT�.�.T T OFFICE USE ONLY Thia request void 18 months from validation date printed in this box.
I(II(I( IINI IIII11lIII lllll IIIiWY�lll Illi IIII �► a° -�
*08582942* �6�
Request Date Rough-In inspeCtion required? � Yes 0 No t�spection Other Than Rough-In: �Ready Now � Will Call
���� �� You must call the inspector when readyl Date Ready:
I, �J licensed contractor ❑ company ❑ owner hereby request inspection of the above electrical work at:
Job Address (SVeet, Box, or Route No.) Ciry Zp Code:
7�36 AtDEN WAY NE FRIDLEY 5543Z
Section No. To�nship Name or No._�N--.-Y-� Range No. Fire No. Counry�a�
���'t SWEt?EEN ELI7ABETH A P� �. -- ---
PoweNu�tier Atldress ^'�
SP
Electrical Contractor / Company Name Contrector License No. Master Lic. No. (Plant Elect. Only)
HUNT ELECT'RiG GGRPGRATION CA 00�98�
Mailing Atldress (Contractor, Company or Owner Performing Installatlon)
230Q TERRfii�1RIA� ROAD , SAINT PAUL, MN 55't 14
Authorized Signature (Con r p r��Owner Perfortning`Ins I'on) Phone Number
l.1 j�'� ( 6s'� 646-29T t
EB-00001A-12 5/1999 STATE BOARD COPY SEE INSTRUCTIONS ON BACK OF YELLOW COPY