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P - 835471 II� �Ill IIIII IIIII 11111 IIIII Illll IIIII IIII Illl '* 0 3 9 2 3 3 � 7* REQUEST FOR ELECTRICAL INSPECTION �,�� Minnesota State Board of Electricity � °' 1821 University Ave., Rm. S-128, St. Paul, MfV 55104 Phone (612) 642-0800 m�`'°��� Home Duplex Apt. Bldg. Other: New Addn Commercial Industrial Farm Remod Repair Air Cond. Htg. Equip. Water Htr. X 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 oi fhe white cqoy only. SAVER'S SWITCH INSTALLATION Calculate Inspection Fee - This Inspecfion 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 tNSPECTOR'S USE ONLY TOTA Sign/Outline Ltg. Xfmr. �� S0 Alarm/Remote ntrol 1 1 Swimming Pool � I hereby certify that I inspected the electrical installation described herein on the dates stated Irrigation Boom Ro�yr,-i� Date Special Inspection Final � D e^ p� � sl Investigative Fee - o l THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS. -- -------�--___--_------------�--_ -_____--- --_______, OFFICE USE ONLY This request void 18 months rom validation date printed in this box. 392-33(�] :� g�� r �s-� JOB NUMBER �9�06�100 PLEASE PRINT OR TYPE Reque�t �a�30 �[j$ Rough-in inspection required? ❑ Yes ❑�Lo Inspection Other Than Rough-In: � Ready Now ❑ Will Call (YOU must call the inspector when ready) Date Ready: 1 1 I 30I98 I, �] licensed contractor ❑ owner hereby request inspection of the above electrical work at: Job Address (Street, Box, or Route No.) City Zip Code �6675 ANOKA ST NE FRIDLEY 55432 Section No. Township Name or No. Rarx�e No. Fire No. County ANOKA Occupant Phone No. RICHARD R BOH�STEEL 574-9635 Power Supplier Address NSP MPLS OF�'ICE Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only) MASTER EGECTRIC CO. INC. C 01192 Mailing Address (Contractor or Owner Performing Installation) Authorized Signature (Contractor or Owner Performing Installation) � --� � Phone No. � � �