P - 83007'' I IIIIII �III (III� IIII) IIII� IIIII IIIII IIIII (III (III 1n82�1 �U�nivers tyOAve.LRm. SR 1C8, StN aPEMN ION04
* 0 3 7 9$ 3 5 2* Phone(612)642-0800
Home Duplex Apt. Bldg. Other: New
Commercial Industrial Farm �Q 'S � Remc
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 SWITCH INSTALLATION
�����
�:;�:�
Addn
Repair
ulate In$oection Fee - This Inspection Request will not be accepted 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 oN�v TOTAL �
Sign/Outline Ltg. Xfmr. 15. �
Swimming F�b61� '* � I hereby certify that I inspected the electrical installation described herein on the dates stated
I rigation Boom Raigh-In Date
peciallnspection '
Final D 5�
Investigative Fee --�2- � /
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.
379-835� 1�� �
� ���� JOH HUMBER �970600�
PLEASE PRIN O TYPE
Request Da Rough-in inspection required? ❑ Yes ❑ N Inspection Other Than Rou h-In:
g ❑ ady Now ❑ Will Call
(You must call the inspector when ready) Date Ready: 6/ 19 / 98
I, ❑ icensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job n��s�t, Box, or R���ORY ST NE c't'k'RI DLEY Z'P `�5432
Section No. Township Name or No. Range No. Fire No. ��� ANOKA
��'P��iNTHIA T GONZALES Pno�eNo. 502-9471
Power Supplier Address
NSP MPLS OF'FICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Ony)
liASTER EL.ECTRIC CO. , iNC. CA01192
Mailing Address (Contractor or Owner Perfaming Installation)
1246? BOONE AVE S. SAVAGE MH. 55378
Authorized Si nature (Contractor or Owner Performing lnstallat' Phone No.
� 6 4 0 .� 94 —4712/890-355
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY �