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REQUEST FOR ELECTRICAL INSPECTION ��'�,
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. j{ 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 ot the white copy only.
SAVER'S SWITCH IRSTALLATION
Calculate lnspection Fee - This lnspection Request will not be accepted without the correct fee:
Other Fee # Service Entrance Siae 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 1�'; SO
Sign/Outline Ltg. Xfmr. ��
Alarm/Remote Control
Swimming oo I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Rough-In Date
Special Inspection
Final � Date
�rwestigative Fee �G �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
_ ^_ --,-,.�.....,.,—� ��
OFFICE USE ONLY This request void 18 months hom validation date printed in this box.
380-431 �]
� �,�, � �v�/ y �
JOB NUMBER #�9706000
PLEASE PRINT OR TYPE
Request p�� 07 / 98 Rough-in inspection required? 0 Yes ❑�o Inspection Other Than Rough-In: �Ready Now ❑ Will Call
/
(You must call ihe inspector when ready) Date Feady:
1, [$ licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
05571 E BAVARIAN PAS FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
MONICA KAY MORAH 572-2116
Power Supplier Address
Electrical Contractor (Compam/ Name) Contracfor License No. Master Lic. No. (Plant ElecT. Only)
Mailing Address (Contractor or Owner Performing Instal ation)
Aut a or r4ii I o Phone No.
EB-00001A-11 8/95� STATE BOARD COPY - S I NS ON BACK OF YELLOW COPY