P - 83661.
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*03633286*
Home Duplex AF
REQUEST FOR ELECTRICAL INSPECTION
Minnesota State Board of Electricity
1821 University Ave., Rm. S-128, St. Paul, MN 55104
Phone(612)642-0800
Other: New
Commercial Industrial Farm Remo
Air Cond. Htg. Equip. Water Htr. X Load Mgmt. Other:
Dryer Range Elec. Heat emp. Service
above the work covered by this request. Enter remarks in this space and on the back ot the white copy only.
SAVER'S SWITCH IHSTALLATION
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 Am
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Addn
Fee
Transformer/Generator INSPECTOR'S USE ONLY TOTAL N O
Sign/Outline Ltg. Xfmr. is.
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
}� Speciallnsp �
Final - � _.,/ � (�
Investigative e / .3 ^ ��
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.
363-328 �
I �- 50 �~� ���
JOB HUtIBER #�970600@
PLEASE PRINT OR TYPE
Request�a� 17 � 9'� Rough-in inspection required? ❑ Yes �lo Inspection Other Than Rough-In: [
(YOU must call the inspector when ready) Date Ready:
I, u licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) Cit
00580 CHERI LN NE F�RIDLEY
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
CHARLES H JOHNSON
Power Supplier Address
NSF MPLS OF'FICE
Electrical Contractor (Company Name) Contractor License No.
![ASTER ELECTRIC CO. , INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE liN. 55378
Author'� Signatu� (Contractoy�br Oyyner Performing Installation)
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Ready Now ❑ Will Call
7/17/97
Zip Code
55421
572-9288
EB-OOOOtA-11 8/95 STATE BOARD COPY �- SEE INSTRUCTIONS ON BACK OF YELLOW COPY
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Master Lic. No. (Plant Elect. Only)
No.
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