P - 83660. I�IIIII �III IIII) IIIII IIIII IIIII IIIII IIIIIlIII IIII
*03639549*
Home Duplex AK
REQUEST FOR ELECTRICAL INSPECTION
Minnesota State Board of Electricity
1821 University Ave., Rm. S-128, St. Paul, MN 55104
Phone(612)642-0800 �
Other:
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New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat emp. Service
"X" above the work covered by ihis 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 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 TOT�S �
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
__ Irrigation Boom _ _ _ Ro�gn-tr, Date
-'- - - -- ... _, _ Final ��i' I Date, /�� `�
Investigative F � �� y' �
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.
363-954�
/���o � � `�3�C�
JOB HUMBER �9706000
PLEASE PRINT OR TYPE
Rough-in inspection required? ❑ Yes ❑i{Jo Inspection Other Than Rough-In: [�i Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: % I 1% I9%
I, [�] licensed contractor ❑ owner hereby request inspection of the above electrical work at:
�o�a��s��reet, Box, o��} C I R NE �`�2I DLEY Z�`��421
Section No. I Township Name or No. I Range No. I Fire No. I County ANOKA
Occupant Phone No.
JULIE L STEGER
Power Supplier Address
NSP MPLS OF'E'ICE
Electrical Contractor (Company Name) Contractor License No.
lIASTER ELECTRIC CO. , INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE ![N. 55378
572-9364
Master Lic. No. (Plant Elect. Only)
Phone No.
941 4712/890-3555
EB-00001A-11 �/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY