P - 84070�I IIII�II�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Mg �jUo ae SaO qeLRm. SR�C8LStNP PEMNIONo4 �����
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I * 0 3 7 1 6 9 6 6* Phone (612) 642-0800
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 ot the white copy only.
SAVER'S SWITCH INSTALLATIOH
Calculate Inspection Fee - This Inspection Request wil/ 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
Swimmin Pool � �� � � '� `�
9 I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In oate
}C Special Inspection 1. S0 p _ �/
Final ZS
Investigative Fee �
`THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from vaiidation date printed in this box.
371-696 � ���
������� JOB NUMBER #9706000
PLEASE PRINT OR TYPE
Requ�tAa�e17 � 97 Rough-in inspection required? ❑ Yes �lo Inspection Other Than Rough-In: � Ready Now ❑ Will Call
YJ
(You must call the inspector when ready) Date Ready: 1 Q) I 1% I 9%
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
00240 LONGFELLOW ST NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
Occupant
HEATHER A
Power Supplier
Electrical Contractor (Company Name)
MA�TFR Rt.FC'TRTC". ["I
Mailing Address (Contractor or Owner Performing
WEST
Address
ANOKA
Phone No.
540-5167
Contractor License No.
11 8/95 STATE BOARD COPY - SEE I�STRdC1M�ON� dF:BACK OF YELLOW COPY
Master Lic. No. (Plant Elect. Only)
Phone No.