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REQUEST FOR ELECTRICAL INSPECTION �,�'��
Minnesota State Board of Electricity � �
1821 University Ave., Rm. S-128, St. Paul, MN 55104
Phone (612) 642-0800 m�`'�'�
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. }t 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 cqoy only.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This Inspection Requesi will not be accepied 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
Sign/Outlirie Ltg. Xfmr. �. 50
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation describetl herein on the dates stated
Irrigation Boom Rough-In Date
}{ Speciallns ti 50
Final , _� D /� �
Investigativ c
THIS INSTALLATION MAY BE ORDERED DISCONNECIED IF NOT COMPLETED WITHIN 18 MONTHS.
OfFICE USE ONLY This request void 18 months from validation date printed in this box.
392-414� ��
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JOB NUMBER #9�06000
PLEASE PRINT OR TYPE
Requegt pa� 30 � 98 Rough-in inspection required? ❑ Yes ❑�lo Inspedion Other Than Rough-In: [,� Ready Now ❑ Will Call
11
(YOU must call the inspecta when ready) Date Ready:
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
00960 HATHAWAY LAl NE FRIDLEY 55432
Section No. Township Name w No. Range No. Fire No. County
axoxg
Occupant PFrone No.
RICHARQ P WOLFE 514-3218
Power Supplier Address
HSP MPLS OF'FICE
Electrical Contractor (Comparry Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
MASTER ELECTRI� C17. , INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
1�46? BDONE AVE S. SAVAGE MN. 55378
Au[Fwrized Signature (Contractor or Owner Performin�n�lation) Phone No. _
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E&00001A-11 8/95 STATE BOARD COPY - SEE INS7RUCTIONS ON BACK OF YELLOW COPY