P - 81074REQUEST FOR ELECTRICAL INSPECTION
0-859'VV� � Minnesota State Board of Electricity
�" 1827 University Avenue Suite S-128, Saint Paul, Minnesota 55104-2993
(651) 642-0800 www.electricity.state.mn.us
Home Duptex Apt. Bldg. Other: New Addn
Commercial Intlustrial Farm Remod Repair
Air Conditioner Htg. Equip. Water Htr. Loatl 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.
N3P SAVER'S SWITCH
Calculate lnspection Fee - This lnspection Reauest will not be accepted withouf the coirect fee.
Mobile Home Park Stall
Street Ltg. / Traffic Sig.
Transformer/Generator
Sign / Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming Pool
0 to 200 Amps
Above 200 Amps
INSPECTOR'S USE ONLY
In
0 to 100 Amps
Above 100 Amps
investigative Fee F� � � - i �� "��' ^ �
THIS INSTALLATION MAY BE ORDERED DI NECTED IF NOT COIIAPLETED WITHIN 18 MONTHS.
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�OFflCE U3E ONIY This request vdd 18 moMhs from validation date printed in this box.
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*08596603* ���
PLEASE PRINT OR TY
Request Dete Rough-In inspection requiretl? � Yes � No Inspection Other Than Rough-In: � Ready Now � Will Call
���� You must call the inspector when ready! Date Ready:
I, �] licensed contractor ❑ company ❑ owner hereby request inspection of the above electrical work at:
Job Atldr eet, Box, Ciry �p C��
��v ��L A1lE NE FRtDtEY 56432
Section No. Township Name or No.w � Range No. Fire No�-�_ Courttywi�_
11�R/RY
Occupant W�KER STEVEN WAtTER Phone No. MM
Powei; upplier Address N�NY
���SP
Electrical Contractor / Company Name Contractor License No. Master Lic. No. (PIaM Elect. Only)
HUNT ELECTRIC CARP�RATION CA 00883
Mailing Address {Contractor, Company or Owner PeAortning Installation)
2300 TERRIT+DRIAL ROAD , SAINT PAUI, MN 56114
Authorized Signature ( nt��ctor,. Qori�pany or Owner Pertorming Ins ion) ry. Phone Number
� ��'t.� i ',"�; !'r�'� � 861) 846-28't1
EB-00001A-12 5/1999 STATE BOARD COPY SEE INSTRUCTIONS ON BACK OF YELLOW COPY