P - 83675I � I I�III�IIII IIII) IIIII IIIII IIII� (IIII IIIII (III (III M8 (n UE a SsatOe B e LR o SR 1C8cStNP PEMN ION04 �����
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* 0 3 6 3 8 9 8 8* 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 SWITCH INSTALLATION
Calculate Inspection Fee - This Inspection Request will not be accepted without the correct tee:
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 TOTAi 5�8$
Sign/Outline Ltg. Xfmr. �
Alarm/Remote Control
SWIfT11'Tllll9 POOI � I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
X Speciallnspecti r0 Finai `/
Investigative Fe �
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.
363-898� � �3$� �
����� JOB HUMBER �9706000
PLEASE PRINT OR TYPE
Request'Jda� 1'� � 97 Rough-in inspection required? ❑ Yes [�lo Inspection Other Than Rough-In: � Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: %� 17 � 9%
I, }J licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
06814 HICKORY ST NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
AxoxA
Occupant Phone No.
ELLSWORTH C NYSTRO[t 571-9052
Power Supplier Address
NSP [iPLS OF'FICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
![ABTER ELECTRIC C0. , INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
1 7 O VE S. SAVAGE M 5537B
Authori Signatur (Contra or r Owner P�forming Installation) Phone No.
5 53 -
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY