P - 84047, II�I�IIIIIIIIIIII�IIIIIIIIIIIIIIIIII�IIIIIIIIIIII 1^82�1 U�niverstOAve.LRm. SReC8, St PaPEMNION04 ����'
Y
* 0 3 7 1 6 4 6 1 * Phone (612) 642-0800 ��`��-�
Home Duplex Apt. Bldg. Other: New Addn
Commercial 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 of the white copy only.
SAVER'S SWITCH INSTALLATION
�ulate Inspection Fee - This Inspection Request will not be accepied wiihout 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. 15. 50
Alarm/Remote Control
Swimming Pod� '"" f` 1 I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
Speciallnspection 1 . 50 �
Final
Investigative Fee —
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
.��� +.i���� ��-��r�� � �r. .i.r�rar�r�..
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
371-646
����9�� ��'�
JOB NUMBER #9706000
PLEASE PRINT OR TYPE
Requ�tAate1.7 / 97 Rough-in inspection required? ❑ Yes f'kAlo Inspection Other Than Rough-In: f.l. Ready Now ❑ Will Call
�J / 1S 7t
(You must call the inspector when ready) Date Ready: �l� �,7 � q,7
I, $] licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
00500 D�VER ST HE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
Occupant
TIMOTHY P
Power Supplier
_NSP
Electrical Contractor (Company Name)
�rec�r�R Fr �r.TR
Mailing Address (Contractor or Owner
12467 BOONE A'
Auth�,�Sig�ature (Contractor or O�
AHOKA
Phone No.
ATCHNER '783-1503
Address
Contractor License No. Master Lic. No. (Plant Elect. Only)
tion)
stallation Phone No.
S/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY