P - 83676I�II�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII M8 QUota SstyOAve.LRm. SR1C8,cSt PaPEMNION04
� 0 3 6 3 3 2 9 4* Phone(612)642-0800
Home Duplex Apt. Bldg. Other: New
�ommercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr. }( Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
above the work covered by this repuest. Enter remarks in this space and on the back of the white copy only.
SAVER'S SWITCH INSTALLATION
:ulate Inspection Fee - This Inspeciion Request will not be accepted without the conect fee:
Other Fee � Service Entrance Size Fee # Circuits/Feeders
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Amps Above 100 Am
���
��.� �'
�a�
Fee
Transformer/Generator INSPECTOR'S USE ONLY TOTAL
Sign/Outline Ltg. Xfmr. 1S.
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
Speciallnspe � .
Final Date �y
Investigative ( �`- 2 —�O
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.
363-329� �
/��50 � �3��
JOB NUMBER #�9706000
PLEASE PRINT OR TYPE
Request�aye 17 � 97 Rough-in inspection required? ❑ Yes �lo Inspection Other Than Rough-In: [x Ready Now ❑ Will Call
(YOU must call the inspector when ready) Date Ready: 7� 17 � 97
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) Ciry Zip Code
01271 HILLWIHD RD HE F'RIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
Occupant
DELBERT J
Power Supplier
NSP
Electrical Contractor (Company Name)
JOHNSON
Address
NPLS OF'FICE
Contractor License No.
ANOKA
Phone No.
571-6508
Master Lic. No. (Plant Elect. Only)
Mailing Address (Contractor or Owner Performing Installation)
Authoriz igna e(Contr or Owner P forming Installa ) Phone No.
�
35��
j� EB- 0001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
�— — – -