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*03798683*
REQUEST FOR ELECTRICAL INSPECTION ���
Minnesota State Board of Electricity � �
1821 University Ave., Rm. S-128, St. Paul, MN 55104 �. .�,�
Phone (612) 642-0800 '�` '"
�e�:
Home Duplex Apt. Bldg. Other: 1 New Addn
Commercial Industrial Farm J� *-S � Remod Repair
Air Cond. Htg. Equip. Water Htr. oad 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 ot the white copy only.
SAVER'S SWITCH INSTALLATION
Calculate InSoection Fee - This lnspection 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.��'
Alarm/Remote Control
SWllllllllll9 POO� I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
pecial Inspection
inal Dat
Investigative Fee - 02 � —
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.
379-868�
��,s� � •
2 J� �J� / JOH NUMBER �9?0600
PLEASE PRINT OR TYPE
Request Da� � 19 � 98 Rough-in inspection required? ❑ Yes ❑ Nav Inspection Other Than Rough-In: ❑ fieady Now ❑ Will Call
A ll
(You must call the inspector when ready) Date Ready:
I, ❑}Qcensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
00I95 HUGO ST NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
axoxA
Occupant phone No.
WARREN M L.AMUSGA 784-1615
Power Supplier Address
NSP MPLS OFFICE
Electrical Contractor (Comparry Name) Contractor License No. Master Lic. No. (Plant Elect. Ony)
KASTER ELECTRIC C0. INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
Authorized Signature (Contractor or Owner Performing Installation) phone No. �
EB-00001A-1 S/95 STATE BOARD COPY - SEE INSTRUCTI S CK OF YELLOW COPY �