P - 83674� � REQUEST FOR ELECTRICAL INSPECTION �....
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* 0 3 6 3 3 1 6 1* Phone (612) 642-0800 �''-°��=`�
I 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
I"X" above the work covered by this requesf. Enter remarks in this space and on the back ot the white copy only.
SAVER'S SWITCH INSTALLATION I
ICalculate Inspection Fee - This lnspection Request will not be accepted without the correct tee:
IOther 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�S o
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 Inspec ' .► .
Final � „� :� Dat C^• -
Investigative F - _. ?" ;;�.__......•----�---_-_..... _ �°,i f %�
THIS INSTALLATION MAY BE ORDERED DISCd-i1NECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLV This request void 18 months from validation date printed in this box.
363-316� � ���� �
/v„�O JOB NUriBER �9706000
PLEASE PRINT OR TYPE
Request aj� Rough-in inspection required? ❑ Yes o Inspection Other Than Rough-In: Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: %��, %� 97
I, u licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No. Cit Zip Code
07355 HAYE� ST HE F�tIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
JAMES G HINRICHS 784-3077
Power Supplier Address
Hs� KP�s oFFZCE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
ltASTER ELECTRIC C0. , INC. CA01192
I Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AYE S. SAVAGE MN. 55378
Authori Signature tractor r ner Perfo ing Ins1�la �) c� Phone No.
�G+ � � � �+ 941 4712/ 890- 3555
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LE-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY -