P - 83669� REGIUEST FOR ELECTRICAL INSPECTION �,�
I' . I�IIII IIIII IIIII IIIII IIIII IIIII IIIII IIII) IIII IIII 1^g21 Uni es ity A earRmf SI 128cSt. Paul, MN 55104 �: _��'
� �;;�.�
* 0 3 6 3 2 7 8 3* 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 of the white copy only.
SAVER'S SWITCH INSTALLATION
Iculate Inspection 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 TOTAL .$O
15:�'
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
Special lnspectio
Final �a.t�`.—(� �
Investigative Fee �/ �
THIS INSTALLATION MAY BE ORDERED DIS ___CTED IF NOT COMPLETED WITHIN 18 MONTHS.
----- -----------i--------- ------ --
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-278�
j5,v-�0 �2�''�38Z� •
JOB NU?IBER �9706000
PLEASE PRINT OR TYPE
Request �i Rough-in inspection required? ❑ Yes ❑�lo Inspection Other Than Rough-In: �
(You must call the inspector when ready) Date Ready:
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) Cit
05586 FILLt10RE ST HE F�tIDLEY
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
CATHERINE !t F'AUCHER
Power Supplier Address
NSP KPLS OFF'ICE
Electrical Contractor (Company Name) Contractor License No.
liABTER EL.ECTRIC CO. , INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. BAVAGE KN. 5537$
Authorize�Sianature ICofitractor Or Owner performing Installation)
Ready Now ❑ Will Call
7/17/97
Zip Code
55432
572-1533
941-
EB-00001A-11 /95 STATE BOARD COPY - SEE IN I S ON BACK OF YELLOW COPY
Master Lic. No. (Plant Elect. Only)
Phone No.
4712/890-