P - 82905RE(�UEST FOR ELECTRICAL INSPECTION
���- 2 7 5� 8121 UniveSsiry A ear Rm. S-128, ISt. Paul, MN 55104
� Phone (612) 642-0800 '� '
X Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Re air
g Air Co g Htg. Equip. g Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above ►he work covered by this request. Enier remarks in this space and on the back of the white copy only.
Calculate Inspection Fee - This Inspection Requesi will noi be accepted without fhe correct fee:
Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 ro 200 Amps 0 to 100 Amps
Sfreet Ltg./Traffic Sig. Above 200 Am s Above 100 Amps
Transformer/Generator INSPECTOR'S USE ONLY TOTAL
Sign/Outline Ltg. Xfmr. 15. 50
Alprm/Remote Control
Swimming Pool
I hereb certi thaf I ins the elechical installation dexribed herein on fhe dates stated
IrriAation Boom Rn��nhAn Date
mvesnganve reev � • ��.� .�. ^ / (�
THIS INSTALLATION MAY BE ORDERED DtSCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
IIIII OFFICE USE ONLY This request void 18 months kom validation date printed in this box.
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PLEASE PRINT OR TYPE
Requesf Dafe Rou h
6-3-98 g-in inspecfion required? ❑ Yes �lo Inspecfion Other Than RougMn: �,] Rea Now
�You musf call ihe inspecfor when ready) pa�. ReO : �' ❑ W�II Call
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I, [�licensed contractor ❑ owner hereby request inspection of the above electrical work at:
lob Address (Street, Box, or Roufe No.�
1080 Gardenia Ave NE c�y Fridley Z�P c 55432
Section No. Township Name or No. Range No. Fire No. Couny
Occupant
Jeanie Whitehill
Power Suoolier
Phone No.
571-7013
"-��� -" """°� Conhacfor License No. Masfer Lic. No. (Ploni Elecf. Only)
Total Electric Inc. CA02749
Mailing Addreu (Conhactor or Owner PerForming Inslollafion) �
1537 92nd NE Blaine MN 55449
Authorized Signature ( hacror or Owner Performi n�lafi �
Phone No.
� ,ti
es-0000,n-7, s� ° ' 786-8484
STATE BOARD P,.. - SEE INSTRUCTIONS ON BACK OF YELLOW COPY