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P - 82848,- i Ifi111 IIIII Illil IIIII IIIII IIIII IIIII IIIII IIII Illi *03798766* REQUEST FOR ELECTRICAL INSPECTION �� Minnesota State Board of Electricity � � 1821 University Ave., Rm. S-128, St. Paul, MN 55104 ��_� Phone (612) 642-0800 �'�`�%° Nome Duplex Apt. Bldg. Other: �� �� New Addn Commercial Industrial Farm Remod Repair Air Cond. Htg. Equip. Water Htr. oad 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 Calculate Inspection Fee - This Inspection Request will not be accepted without the cwrect 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 TOTAL ,s'D Sign/Outline Ltg. Xfmr. 15.'��' Alarm/Remote Control Swimming Pool I hereb cert� that I ins y fy pected the electrical installation described herein on the dates stated Irrigation Boom Rough-In Date pecialinspec' n �'j� 0 �� Investigative F �. z�"'_ � THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED_WITH�N 1$ MOl�1T1iS. —_ OFFICE USE ONLY This request void 18 months from validation date printed in this box. 379-876�] r ��� � � 5 �+-�3�q JOB NUMBER #970600 PLEASE PRINT OR TYPE Request Dag � 19 � 138 Rough-in inspection required? � Yes ❑ Ndx Inspection Other Than Rough-In: ❑�ady Now ❑ Will Call (Yai must call the inspector when ready) Date Ready: � � I, ❑Xicensed contractor ❑ owner hereby request inspection of the above electrical work at: Job Address (Street, Box, or Route No.) City Zip Code 00132 CHRISTENSON CT N FRIDLEY 55432 Section No. Township Name or No. Range No. Fire No. County nxoxA Occupant Phone No. � NANCY B LINDGREN 506-1700 Power Supplier Address NSP MPLS OPFICE Electrical Contractor (Comparry Name) Contractor License No. Master Lic. No. (Plant Elect. Ony) MASTER ELECTRIC CO. INC. CA01192 Mailing Address (Contractor or Owner Performing Installation) Authorized Si t ntractor or Owner Performing Installation) 2 6 Phone No. EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY