P - 83018„1 I�111I�IIII (IIII IIIII IIIII IIIII IIIII II�I� �III I�II
*0`3798147*
REQUEST FOR ELECTRICAL INSPECTION �'��
Minnesota State Board of Electricity � °”
1821 University Ave., Rm. S-128, St. Paul, MN 55104 �
Phone (612) 642-0800 '�`"�''6�`
Home Duplex Apt. Bldg. Other: ti New Addn
Commercial Industrial Farm � � �� Remod Repair
Air Cond. Htg. Equip. Water Htr. oad Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above the work covered by this repuest. Enter remarks in this space and on the back of the white copy only.
SAVER'S SWITCH INSTALLATION
Calcu/ate Inspection Fee - This Inspeciion Request will not be accepted without the correct fee:
Other Fee # Service Entrance Size Fee +s 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
TransformerlGenerator - wsPecroR•s use oN�v TOTAL �
Sign/Outline Ltg. Xfmr. 15. $�'
Alarm/Remote Control
Swimming Po ~ I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
peciallnspection S.0
Final
Investigative Fee �'zs^
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF N07 COMPLETED WITHlN 18 MONTHS.
OFFICE USE ONLY This request void 78 months from validation date printed in this box.
379�81 �] � �
l�
� � �� � JOB NUMBER �970600
PLEASE PRINT OR TYPE
Request Da� � 19 �,38 Rough-in inspection required? � Yes ❑ Ndx Inspection Other Than Rough-In: ❑�ady Now ❑ Will Call
(You must call the inspectw when ready) Date Ready:
I, ❑}�censed contractor ❑ owner hereby request inspection of the above etectrical work at:
Job Address (Street, Box, or Raute No.) City Zip Code
00130 CHRISTENSON CT N FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. Couniy
AHOKA
Occupant Phone No.
JEAN C CHRISTOFF'ERSOH 572-9875
Power Supplier Address �
NSP MPLS OFFICE
Electrical Contractor (Comparry Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
ttASTER ELECTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE N. 55378
Authorized Signature (Contractor or Owner Performing Installation) 4 r Ptwne No
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EB-0OOO1A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY