P - 83656I II0lI4�IIII (IIIIIIIIIIIIII IIIIIIIIII IIIIIIIII IIII M8 QUoia SsatOe B aLRm. SR1C8, St Pau�IEMN 5O5N04
" * 0 3 6 3 8 7 5 6* Phone(612)642-0800 �
Home Duplex Apt. Bidg. Other: New
Commercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr. 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 of the white copy only.
SAVER'S SWITCH INSTALLATION
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n Add�
Calculate Ins,oection Fee - This Inspection Request will not be accepted without the correct fee:
Other Fee � Service Entrance Size Fee n 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 � j��
Sign/Outline Ltg. Xfmr. j, rj. �-
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
3{ Speciallnsp i � . 0
Final D te
Investigative � 2 .-- �
^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.
�63-875� � �
l�SZ� � �38 �
JOB HUMBER �9706000
PLEASE PRINT OR TYPE
"`4"°"!°cYcl // 7/ Rough-in inspection required? ❑ Yes �lo I Inspection Other Than Rough-In:
(You must call the inspector when ready) Date Ready:
I, }� licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City
06218 CAROL CIR NE FRIDLEY
Section No. Township Name or No. Range No. Fire No. County
AHOKA
Occupant
SUSAN Ii
Power Supplier
Electrical Contractor (Company Name)
liAILE
Address
Mailing Address (Contractor or Owner Performing
Performing
PLS OE'FICE
Contractor License No.
Phone No.
Ready Now ❑ Will Call
7/17/97
Zip Code
55432
572-1684
1A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
Master Lic. No. (Plant Elect. Only)
Phone No.