P - 81058REG�UEST FOR ELECTRICAL INSPECTION
.' Q'855_737 � Minnesota State Board of Electricity - _
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104-2993
(651) 642-0800 www. electricity. state. mn. us
Home Duplex Apt, Bldg. Other: New Atldn
ommerciat Intlustrial Farm Remod Repair
Air Conditioner Htg. Equip. Water Htr. oatl 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.
NSP SAVER'8 SVI�TCH INSTALtAT1ON
y � � ���
Ca/cu/ate Inspection Fee - This Inspection Requesf will not be accepted without the correct fee.
Other Installations 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
Sian / Outline Lta. Xfmr.
Irri ation Boom i neret
Rough
S ciallnspection ��
Final
Investigative Fee
THIS INSTALLATION MAY BE OR
i lillll ilili IIIII lilll lilll IIli�llll IIII IIII
*08557373*
that 1
TOTAL
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the electrical installation described herein on the dates stated:
oate ^ � /���,�
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IE NNECTED IF NOT COIYIPLETED WITHIN 18 MONTHS.
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OFFlCE U8E ONIY This requeffi vdd 18 montlis fiom validation date printed in this box.
��� � NUMBER #f98pB069
d 70
PLEASE PRINT OR TYPE
Request Date����g Rough-In inspection required? ❑ Yes L7 No Inspection Other Than Rough-In:'LJ Ready Now 0 Will Call
You must call the inspector when ready! Date Ready:
I, ❑ I�ensed contractor ❑ company ❑ owner hereby request inspection of the above electrical work at:
Job Atldress (Street, Box, or Route No.) City FRIDLEY ZiP Code: �32
07345 BAKER ST NE
Section No. Township Name or No. Range No. Fire No. County
Occupant Pho�e No.
QUALITY EQUIP & SERV INC a92-784-1079
Power Supplier Address
NSP MPLS OFFI CE
Electrical Contractor / Company Name Contractor L�nsg„N�� �2 Master Lic. No. (Plant Elect. Onty)
MAST�R ELEC7RIC CO.,1NC. '4c�
Mailing Address (Contractor, Company or Owner Performing Installation) •
12487 BOONE AVE S, SAVAGE, MN, 553�8 �-(612�41-4712 I(1392j�0-3555
Auth ' ignature (Contractor, Company or Owner Performing Installation Phone Number
. �� ( )
EB-00001A-12 5/1999 STATE BOARD COPY SEE INSTRUCTIONS ON BACK OF YELLOW COPY