P - 82857` ME n�esota S at�e B aLd of EReCA�LtyNSPECTION �,�;��,
-� II�III ��I IIIII (IIII IIIII (IIII (IIII IIIII (III IIII 1821 University Ave., Rm. S-128, St. Paul, MN 55104 �.;$:�
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* 0 3 7 9 8 5 5 p''�' Phone (612) 642-0800 �`
Home Duplex Apt. Bldg. Other: New Addn
��� .sc
Commercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr. oad Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
X" above the work covered by this request Enter remarks in this space and on the back of the white cqoy only.
SAVER'S SWITCH INSTALLATIOH
Calculate Inspeciion 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 TOTAL 15.
Sign/Outline Lt . Xfmr.
Alarm/Remot t
Swimming Pool i hereby ce�
rigation Boom ough-In
Special Inspection
Final
Investigative Fee
THIS INSTALLATION MAY BE ORDERED
that I inspected the electrical installation described herein on the dates stated
Date
IF NOT COMPLETED WITHIN 18
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
379-855� 5 �j i
I � rQ -.� ���� JOB HUMBER �970600
��.
PLEASE O PE
Request Da Rough-in inspection required? ❑ Yes ❑ No Inspection Other Than Rough-In: ❑ eady Now �y-�I�,Will Call
(You must call the inspector when ready) Date Ready: 6I 1?�98
I, ❑ licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job A�����t, Box, o� R��� STENSON CT N'tyFR I DLEY Z'P �5432
Section No. Township Name.w No. Range No. Fire No. County pNOKA
°o°°"�bBERT 3ATtES JOHDISTON IPhoneNo. S%4-1951
Power Su lier Address
N�P MPLS OFFICE
Electrical Contractor (Comparry Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
liASTER ELECTRTC CO. , INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE MN. 55378
Authorize Si re (Contractor or Owner Performing Installation) � �+ r� Phone No.
� V � � ` 94 —4712/890-35
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY