P - 84041�
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�" 0 3 7 1 6 2 2 2* Phone (612) 642-0800
Home Duplex Apt. Bldg. Other: New
Commercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr. X Load Mgmt. Other:
Dryer Range Elec. Heat emp. Service
" above the work covered by ihis request Enter remarks in this space and on the back of the white cqoy only.
SAVER'S SWITCH INSTALLATION
���� _
,�..��
Addn
Repair
Calculate Inspecfion Fee - This Inspection Requesi 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 INSPECTOR'S USE ONLY TOTAL
Sign/Outline Ltg. Xfmr. 15. J0
Alarm/Remote C trpl
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
X Speciallnspection 1 . 50 �/
Investigative Fee F��ai l — L��— q Q
7 L
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
371-622 � ���
/� �-��95
JOB NUMBER �9706000
PLEASE PRINT OR TYPE
Requ�tAa�1,7' �7 Rough-in inspection required? ❑ Yes ❑�Jo Inspection Other Than Rough-In: 1.1. Ready Now ❑ Will Call
V1 7i
(You must call the inspector when ready) Date Ready: �'� �,7 � q,7
I, $] licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
07919 BROAD AVE NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
Occupant
JOANNE MARIE
Power Supplier
NSP
Electrical Contractor (Company Name)
MA!4T�R FI _Ff'TR'
Mailing Address (Contractor or Owner
Axoxa
Phone No.
CARLSON 717-4820
Address
Contractor License No. Master Lic. No. (Plant Elect. Only)
�nature (Gontractor or Owner Performing Installationj - - [j p- �^� I Phone No.
% `1 � •�
IV QJ � Fd
r.w • ..r. n
1 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY