P - 83602��IIII�I���IIIII�IIIIIIIIlII11IlIlIIIIllillllllll 1^82�1 U�niv SstyOAve.LRm. SR1C8,cSt PaPEMNION04 � ���,
�* 0 3 9 2 4 0 9 9* Phone (612) 642-0800 ��:��
Home Duplex Apt.8ldg. 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 Inspection Fee - This Mspection Request will not be accepted without the correct tee:
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
TransformerlGenerator INSPECTOR'S USE ONLY TOTA�r 50
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swifllll'ling POOI I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
Specia •
Fnal D te
Investig iv F e — 2/
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request woid 18 rtanths trom validation date printed in this box.
392-409,� �s.�
/�
JOB NUMBER #9�06000
PLEASE PRINT OR TYPE
Reque�t QaJk 3 ja � C�8 Rough-in inspection required? ❑ Yes ❑�o Inspection Other Than Rough-In: [}{ Ready Now ❑ Will Call
(YOU must call the inspector when ready) Date Ready: 1 �/ 30/ t38
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
08i12 FAIRMONT CIR NE FRIDLEY 55432
Sec[ion No. Township Name or No. Range No. Fire No. County
AN�KA
Occupant Phone No.
G�►RY W VELISHEK 786-6133
Power Supplier Address
NSP MPLS OFF'ICE
Electrical Contractor (Comparry Name) Con[ractor License No. Master Lic. No. (Plant Elect. Only)
MASTER ELECTRIC C0. INC. CA01i92
Mailing Address (Contractor or Owner Perfaming Installation)
12467 BOOHE AVE S. SAVAGE MN. 55378
Authorized Signature (Contractor or Owner Performing Installation) PFwne No.
EB-00001A-11 8/g5 STATE BOARD COPY - SEE IN CTIONS ON BACK OF YELLOW COPY