P - 83876REQUEST FOR ELECTRICAL INSPECTION
5 3 9� 4 1 � � Minnesota State Board of Electricity
1821 University j4ve., Rm,� S-128, St. Paul, MN 55104 '
C I TY Phone (612) 642-0800
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod X Re ir �
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
I,X,�JTM184$°rk cNEWd (�REPLA9CE ) E200A �SERVICs�ace and on the back of the white copy only.
Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee:
Other Fee # Service trance ' e Fee # Circuits/Feed
Mobile Home Park Stall � 0 20 mps 5. �� 0 to 100 Amp
$treet Ltg./Traffic Sig. Above 200 Amps Above 100 Am
Transformer/Generator INSPECTOR'S USE ONLY TOTA
Siqn/Outline Ltq. Xfmr.
Alarm/Remote Control
Swimminq Pool
ihaf I ins fhe elechical installation dexribed herein on ihe da
Date
Fee
r,
Speciallnspec' �
Final - �
Investigative Fee _ _ —
_THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This requesf void 18 monfhs from validafion date prinfed in rhis box.
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7k y� PLEASE PRINT OR TYPE
Requesf Date Rou h-in ins ecfion r uired?
10 / 8/ 9 7 n. 9 P � � Yes `�C] No Inspecfion O1Fier Than Rough-In:
ou must call fhe inspecfor when ready) � Date Ready:
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address �Sheef, Box, or Roufe No.) City
6740 KENNASTON DR. FRIDLEY
Section No. Township Name or No. Range No. Fire No. County
Occupanf
GARY MUNSON RESIDENCE�KAREN)
Power Supplier Address
NSP 3115
Eleckical Contracfor (Company Name)
MUSKA ELECTRIC COMPANY
Mailing Address �Conhacfor or Owner Performing Insfallation)
1985�qKCREST AVE. ROSEILILL
%�-��„��.� --
11 8/96 STATE BOA
Ready Now �] Will Call
/
Zip Code
�5432
Phone No.
730-8148-572-4429
CENTER POINTE DR. ROSEVILLE, MN
Conkacior License No. Masfer Lic. No. �Plant Elect. Only
CA01287
E, MN 55113
� � J
Phone No.
636-5820