P - 82837' I�I�III�IIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIII ( Mg� Uo aerstyOAveLRm SRiC8, StN aPEMNIONo4 ����`
� * 0 3 7 9 9 2 Q 2* Phone (612) 642-0800 �����
Home Duplex Apt. Bldg. Qf�er: New Addn
Commercial Industrial Farm ��v Remod Repair
Air Cond. Htg. Equip. Water Htr. .� oad Mgmt. Other: rJ G��1
Dryer Range Elec. Heat Temp. Service
"X" above the work covered by this requesi. Enter remarks in this space and on the back of the white copy only.
SAVER'S SWITCH INSTALLATIOH
Calculate Inspection Fee - This Inspect�on 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 ��j
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming P I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Bo Rough-In Date
pecial Inspection
mal D
Investigative Fee
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request wid 18 months from validation date printed in this box.
379-920�
�f� ��3! t
��� � v � JOB NUMBER �970600
PLEASE PRINT OR TYPE
Request Da� � 1 g � 98 Rough-in inspection required? ❑ Yes ❑ Ncv Inspection Other Than Rough-In: ❑ Aeady Now ❑ Will Call
A ll
(You must call the inspector when ready) Date Ready:
I, ❑}{censed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
07356 E RIVER RD FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
Power Supplier Address
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
Mailing Address (Contractor or Owner Performing Installati n)
No.
EB-00001A-11 S/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW