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Home Duplex Apt. Bldg. Other: New
Commercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr. Load 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 ihe white copy only.
SAVER'S SWITCH I1ISTALLATION
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Addn
Calculate Inspection 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
Sign/Outline Ltg. Xfmr. 1S. 50
Alarm/Remote Control
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Swimming P I� I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom � Rough-In Date
Special Inspection
Final - Date
Investigative Fee —
THIS INSTALLATION MAY BE ORDERED DISCO ECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
371-619 [� ���
R�� ��� JOB NUMBER #9706000
PLEASE PRINT OR TYPE
Requ Rough-in inspection required? ❑ Yes o Inspection Other Than Rough-In: Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: , Q) � 1%� 9%
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
00285 CRAIGBROOK WAY NE RRIDLEY 55432
��, Section No. Township Name or No. Range No. Fire No. County
ANOKA
' Occupant Phone No.
JEE'F' BRANDT 574-9941
Power Supplier Address
NSP lIPLS OFFICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
MASTER ELECTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE MN. 553'76
Autho ' ig ure (Contractor or Owner Performing Installation) Phone No.
� � �' � �� 941 4712/890-3555
=B-00001 - 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY �