P - 83671I
I �I II�II �III (IIII IIIII IIIII IIIII IIII) IIIII IIII IIII M$ n� UE a SsatOe B e LR of SR 1C8cs{NP PEMN I ON04 ����
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I * 0 3 6 3 3 2 6 0* Phone(612)642-0800
Home Duplex Apt. Bldg. 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 S4IITCH INSTALLATION
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 ONLY TOTA�5: �
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 Ins oa e
Final C�
Investigative e L ` �'^ �! �
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.
363-326� /5,so � �3 � d
PLEASE PRINT OR TYPE
JOB NUMBER �f9706000
Rough-in inspection required? ❑ Yes �lo Inspection Other Than Rough-In: jX Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: %� 1%� 9%
I, u licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No. Cit Zip Code
01413 GARD�NA AVE NE F�2IDLEY 55432
Section No. � Township Name or No. I Range No. I Fire No. I County
Occupant Phone No.
ANN MARIE JOHNSON
Power Supplier Address
NSP ltPLS OFFICE
Electrical Contractor (Company Name) Contractor License No.
MASTER ELECTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOOKE AYE S. SAVAGE ltN. 55378
AHOKA
572-A549
Master Lic. No. (Plant Elect. Only)
�u� ri Signatur�ac ner Performing,�ps�ation) � Phone No.
, �, 3!� 991 4712/890-3555
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY