P - 83654- I III�II �III IIIII IIIII IIIII IIIII IIIII �IIII IIII IIII M8 � Uo a SsatOe B e�R of EReot8 StNP PEnCN ION04
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* 0 3 6 3 9 4 6 5* Phone(612)642-0800
Home Duplex Apt. Bidg. Other: New
Commercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr. X Load Mgmt. Other:
Dryer Range Elec. 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.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee:
Other Fee # Service Entrance Size Fee # Circuits/Feeders
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 ONLV TOTAL
15,
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
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a,
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Addn
Repair
Fee
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
X Special Inspection F.�ai e �^ �
Investigative F '
_ _THIS INSTAL __�„__,_�ORDERED DISC ��ECTED IF NOT COMPLETED WITHIN 18 MONTHS.
� � OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-946 �] �� ��j
/5`sv JOB NUMHER �9706000
PLEASE PRINT OR TYPE
Request'�alk 1'7 � G�'� Rough-in inspection required? ❑ Yes �{Jo Inspection Other Than Rough-In: �( Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: %��, %� 9%
I, �] licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
06160 BENJAMIN ST NE FRIDLSY 55432
Section No. Township Name or No. Range No. Fire No. County
AHOKA
Occupant Phone No.
JOHN R SIMON 571-6604
Power Supplier Address
�gp MPLS OF'FICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
KASTER ELECTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVACE MN. 553T8
Aut � ed Signature ( ntractor or wner Performing In$xla�)� �� Phone No.
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� EB-OOOOtA-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY