P - 83065IIIiII��IIIIIII�I�I�IIIII1IlIIIIIIII�I1�lIIIIIIII 1n82�1 U�iverst0 BeLRo SR1C8 St PauPIEMN 5O5N04 ����_
�* 0 3 8 6 9 2 7 8'� Phone (612) 642-0800 �`�y�
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. oad Mgmt. Other:
Dryer Range Eiec. Heat Temp. Service
X" above the work covered by this request Enter remarks in this �uace and on the back ot the white copy only.
SAVER'S SWITCH INSTALLATION
�ulate In,s�ectron Fee - This Inspectron Req�est will not be accepted without the correCt fee:
Other Fee x 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
Sign/Outline Ltg. Xfmr. 15. �0
Alarm/Remote tr I
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rou9n-in Date
pecial Inspection 15. � Final o
Investigative Fee -,- g ^
-
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
.r—_.—.r� .._._ -__----------�—�---------�------------ -------
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
386-927� �5:
+� �-�,�
JOB NUMBER �970600
PLEASE PRINT OR TYPE
Request Da Rough-in inspection required? ❑ Yes ❑ N Inspection Other Than Ro h-In:
� / 14 / 98 �}{ � ❑ �ady Now ❑ w�n cau
(You must call the inspector when ready) Date Ready:
I, ❑ i�%ensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
05946 HACKMANN AVE NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
Occupant
NATI
Power Supplier
ANdKA
Phone No.
CARLSOH 5?2-07
Address
Electrical Contractor {Company Name) Contractor License No.
Mailing Address (Contractor or Owner Performing Installation)
Authorized Signature (Contractor or Owner Performin9 Installation)
♦ i
EB-00001A-11 8/95 STATE BOARD COPY - SEE INS7RUCTIONS ON BA OF YELLOW COPY
Master Lic. No. (Plant Elect. Ony)
Phone No.