P - 83667� f-
I�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII M8 n�esotae sa0 B aLR� SRIC8CS[ PSPEfCNION04
* 0 3 6 3 2 4 3 7* Phone(612)642-0800
Home Duplex Apt. Bldg. Other: New
Commercial Industrial Farm Remc
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 of the white copy only.
SAVER'S SWITCH INSTALLATION
���
��-
��.,���
�Addn�
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 ONLV TOTAL �
Sign/Outline Ltg. Xfmr. 15.
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irriaation Boom Rouah-In Date
Speciallnspe .00 Finai o ,p
Investigative e �) -�'��U
.
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.
363-243�] � �,,�3$�
/�;so
JOB NUMBER #9706000
PLEASE PRINT OR TYPE
Requesr�� 17 �97 Rough-in inspection required? ❑ Yes �lo Inspection Other Than Rough-In: � Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: '� � 1'� � 9"f
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
00534 FAIRMONT ST NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant � Phone No.
ROLAN WAYNE BITZER
Power Supplier Address
NSP MPLS OFFICE
Electrical Contractor (Company Name) Contractor License No.
Mailing Address (Contractor or Owner Performing Installation)
784-3009
Master �ic. No. (Plant Elect. Only)
Autho' Signa r(Contr � d��ei � rf ,jpg Installation) Phone No.
� �//% I tJ -��
�[J
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY