P - 83416� I�IfH IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII
*03788$82*
REQUEST FOR ELECTRICAL INSPECTION ��
Minnesota State Board of Electricity �' q �".
1821 University Ave., Rm. S-128, St. Paul, MN 55104
Phone (612) 642-0800 ��` '�
�.�
Home Duplex Apt. Bidg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above the work covered by this request. Enter remarks in this space and on the back ot the white cqoy only.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This Inspection Request will not be accepted without the conect fee:
Other Fee � Service Entrance Size Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Amps Above 100 Amps
Transformer/Generator INSPECTOR'S USE ONLY TOTAL
Sign/Outline Ltg. Xfmr. 15. 50
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigatiofi Rough-In Date
X Special s . 50
Final D ��
Investigative Fee c�
THIS INSTALLATION MAY BE ORDERED DISCO CTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
378-888� • �S� S�
�i3 �
JOB HUMBER #9706000
PLEASE PRINT OR TYPE
Reques��l �� 9$ Rough-in inspection required? ❑ Yes �lo Inspection Other Than Rough-In: Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: (j I.�. G I98
I, u licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) Ciry Zip Code
05589 E OBERLIN CIR FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
HILMER S FERKINGSTAD 574-1317
Power Supplier Address
NSP MPLS OF'E'ICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
MASTER ELECTRIC C!]. , IHC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOOHE AVE S. SAVAGE MN. 55378
A or' ed Si nature (Contractor or Owner Performing Installation) Phone No.
941 4712/890-3555
EB-00001A-11 /95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY