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* 0 3 7 1 6 4 5 3* Phone (612) 642-0800
Home Duplex Apt. Bldg. Other: New
Commercial Industrial Farm Remo
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.
SAVE}2'S SWITCH INSTALLATION
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Addn
Repair
Calculate Inspection 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 ONLY TOTAL
Sign/Outline Ltg. Xfmr. 15. 50
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 Inspection
Final J _ Date
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.
371-645 [� ��� �p �
��p��`� JOH NUMBER #9706000
PLEASE PRINT OR TYPE
� Reque�t�a�el'7 � 9'� Rough-in inspection required? ❑ Yes ['�Jo Inspection Other Than Rough-In: � Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: 0� '� � C,'�
I, �] licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
01313 HILLWIND F{D NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
Occupant
SHARON VALENTIHE
Power Supplier
NSP
Electrical Contractor (Company Name)
ANOKA
Phone No.
HATCHET 5'71-0724
Address
MPLS OF'FICE
Contractor License No. Master Lic. No. (Plant Elect. Only)
Mailing Address (Contractor or Owner Performing Installation)
(Contractor or Owner Performing Installation)
EB-00001A��/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
Phone No.