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.
� � �