P - 83680�' I II�II IIIII IIIII IIII) IIIII IIIII IIIII IIIII IIII IIII 1n82�1 U�niverstyOAve.LRm. SR1C8, St PaPEMN 5O5N04 �,����'_
* 0 3 6 3 2 7 3 4* Phone (612) 642-0800 ����_�%�
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
" above the work covered by this request. Enter remarks in this space and on the back of the white copy only.
SAVER'S SWITCH IHSTALLATION
Calculate lnspection Fee - This Inspection Request will not be accepted without the coneci 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 n
Sign/Outline Ltg. Xfmr. ir'J.
Alarm/Remote Control
SWII711'Ttlllg POOI I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
}C Speciallnspection i . 0(a
Final � �.. •� Date
Investigative F � — jC �/� _�'°'
THIS INSTALL ORDERED DISCONNECTED IF NOT COMPLETED WtTHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-273 �f # � � � a �
/�� S�
JOB NUMHER #�9706000
PLEASE PRINT OR TYPE
neyues� �aye 1// 7/ Rough-in inspection required? ❑ Yes ❑)(lo Inspection Other Than Rough-In: �
(YOU must cali the inspector when ready) Date Ready:
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City
00676 KIMBALL ST NE FRIDLEY
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant
SUZANNE K
Power Supplier
Electrical Contractor (Company Name)
Mailing Address (Contractor or Owner Performing
EGAN
Address
MP
Ready Now ❑ Will Call
7/17/97
Zip Code
55432
Phone No.
786-9135
Contractor License No. � Master Lic. No. (Plant Elect. Only)
Autno rzetl Sign ture (G t ctor or Owner Perf i Installation) Phone No.
�'�35 �
EB-00001A-1 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY