P - 83405;(�I�I IIIII IIIII IIIII IIIII IIIIIIIIII IIIII IIII IIII 1n82�1 U�niv SstyOAve.LRm. SR1C8,cSt PauPIEMN 5O5N04 � ��
� * 0 3 7 8 8 9 4 0* Phone (612) 642-0800 �����
Home Duplex Apt. Bldg. Other: New Addn
Commerciai Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. Load 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 ot the white copy only.
SAVER`S SWITCH INSTALLATION
Calculate Inspection Fee - This lnspection Request will not be accepted 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
Sign/Outline Ltg. Xfmr. 15. 50
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rou9n-in Date
)( Speciallnsp 50
Investigati Final Da � �_
THIS INSTALLATION MAY BE ORDERED DISCO NECTED IF NOT COMPLETED WITHIN 18 MONTHS.
�--------- -.--�-r .-��.�..
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
378-894�] � ,,�
� y�3�
JOB NUMBER �9706000
PLEASE PRINT OR TYPE
Reques��16 � 98 Rough-in inspection required? 0 Yes �lo Inspection Other Than Rough-In: � Ready Now ❑ Will Call
(You must call ihe inspector when ready) Date Ready: (7I 1 G I 98
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
�017? CHRISTENSON CT NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
MARY LLOYD JONES 571-4725
Power Supplier Address
NSP IiPLS OFF'ICE
Electrical Contractor (Comparry Name) Contractor License No. Master Lic. No. (Plan[ Elect. Only)
MASTER ELECTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOOME AVE S. SAVAGE ![N. 55378
A�r�d Sig�ature (Contractor or Owner Performing Installation) Phone No.
EB-00001A-1�/95 STATE BOARD��-�F��$f�UCTIONS ON BACK OF YELLOW COPY
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