P - 82839�����i1 ����� ����� ����� ����� ����� ����� ����� ���� ����
� *03799160*
REQUEST FOR ELECTRICAL WSPECTION �,��
Minnesota State Board of Electricity � �'
1821 University Ave., Rm. S-128, St. Paul, MN 55104 ,,,��
Phone (612) 642-0800 ��"���� �
Home 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 ihis request. Enter remarks in this space and on the back of the white cqoy only.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This Inspection Request will not be accepied without the correct tee:
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 ,SO
Sign/Outline Ltg. Xfmr. 15. �'
Alarm/Remote Control
Swimming P � I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation B Rough-In Date
pecial lnspection
inal Da �-
Investigative Fee �'�
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
,-�.--.�.�.-,r
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
379-91 � J �� �µ� � �
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JOB NUMBER �970600
PLEASE PRINT OR TYPE
Request Da� � 1,9 � 9$ Rough-in inspection required? ❑ Yes ❑ N� Inspection Other Than Rough-In: ❑ Aeady Now ❑ Will Call
n
(You must call the inspector when ready) Date Ready:
I, ❑}(icensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
00146 CHRISTENSON CT N FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
DIANNE TUREK 574-9131
Power Supplier Address
NSP MPLS OFF'ICE
Electrical Contractor (Company Name� Contractor License No. Master Lic. No. (Plant Elect. Only)
ltASTER ELECTRIC C0. INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
Authrnized Signature (Contractor or Owner Performing Instatlation) 2 6 3� 9 Phone No.
EB-00001A-11 S/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY