P - 83549, II�I���IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII R82�1 UEiSersFORve.LRm. SRiC8, St PaPEMNION04 ����� _
Minnesota State Board of Electriaty � `"
* * Phone (612) 642-0800 ��'°�'-''°
03923372
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 emp. Service
"X" above the work covered by this request. Enter remarks in this space and on the back of the white cqoy only.
SAVER'S SWITCH INSTALLATION
Calculate In$oection 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 TOTA
Sign/Outline Ltg. Xfmr. �. 50
Alarm/Remote Control
Swimming Po01 I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
X Special Inspec ' . 50
Final Date
Investigative F � �` ( Z� —
� THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
� OFFICE USE ONLY This request void 18 months from validation date printed in this box.
392-337�] �a�, � �
JOB HUMBER #9�6000
PLEASE PRINT OR TYPE
Requeft 4at� �0 � 98 Rough-in inspection required? ❑ Yes ❑xo Inspection Other Than Rough-In: [x Ready Now ❑ Will Call
(You must call the inspecta when ready) Date Ready
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Bax, ar Route No.) City Zip Code
07330 EVERT CT HE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant PFwne No.
JIM F CHAPMAN 717-9203
Power Supplier Address
NSP MPLS OFE'ICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Ony)
MASTEK ELECTRIC CO. INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE MM. 5537
Authorized Signature (Contr ctor or Owner Performing Installatio ) Phone No.
^m' � ( !? �
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY