P - 83553I����I IIIII IIIII IIIII IIIII IIIII IIIII (IIII IIII IIII
*03923422*
REQUEST FOR ELECTRICAL INSPECTION ���
Minnesota State Board of Electricity �'
1821 University Ave., Rm. S-128, St. Paul, MN 55104 �.
Phone (612) 642-0800 a`�"�`=�
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
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.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This Inspection Request will not be accepted without the coRect 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 TOTA�� 5�
Sign/Outline Ltg. Xfmr.
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
Speciallnspect' : ,
Final Date
Investigative Fe t� v Z-� �— j�
THIS INSTALLATION MAY BE ORDERED DIS(�ONN D IF NOT COMPLETED WITHIN 18 MONTHS.
�-- tr- .-, . r-.W-.��..�..�r__�._......3..._.�.-r.--r-�.�.-.� - � + .
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
392-342� ��,��� ���
JOB HUMBER �9�06000
PLEASE PRINT OR TYPE
Reque} �a�E 3 � 8 Rough-in inspection required? ❑ Yes ❑ o Inspection Other Than Rough-In: Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: 11 / 3Q►/ 9$
I, L7 licensed contractor ❑ owner hereby request inspection of the above electrical work at:
,bb��s��,,�treet, Box, orLR��r�.�,ELLOW ST NE ��? I DLEY Z�P�432
10
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
LA4fRENCE B DAVIS 786-5824
Power Supplier Address
NSP MPLS OF'FICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Onry)
KASTER ELECTRIC CO. , INC. CA011�32
Mailing Address (Contractor or Owner Performing Installation)
i2467 BOONE AVE S.SAVAGE MN. 55378
Authorized Signature (Contractor or Owner Performing Installation) �- t' ' ,C. Phone No.
� �"'� 941 471�/89
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY