P - 83019�r �f�IIII11IIlIIIIII1IlIIIIIIIIIIIIIII�II1IIIIIIIIII M8 Q ��S SsFO gve.LRm SR1C8, St PaPEMNION04 ����
* 0 3 8 0 4 3 5 8* Phone (612� 642-0800 '������
Home Duplex Apt. Bldg. Other: s- New Addn
Commercial Industrial Farm �� J� Remod Repair
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat emp. Service
"X" above the work covered by this request. Enter remarks in this space and on the back ot the white copy oniy.
SAVER'S SWITCH IAISTALLATION
Calculate Inspection Fee - This lnspection Request will not be accepted withoui 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 2Q0 Amps Above 100 Amps
Transformer/Generator INSPECTOR'S USE ONLY TOTAL /.S�SO
SignJOutline Ltg. Xfmr. �e
Alarm/Remote Control
SWItTlfillllg P 1 hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Bo Ro�gn-in Date
Speciallnspection •
Final Dat
Investigative Fee —� -
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.
38�-435�] 5 �� �
/ �� 7�� 308 NUMBER �9?06000
PLEASE PRINT OR TYPE
Request t Rough-in inspection required? ❑ Yes ❑ Inspection Other Than Rough-In: Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: % I 0% � 98
I, licensed contractor ❑ owner hereby request inspection of the above electrical work at:
�ob���eet, Box, or��te�v�)C LN NE �R I DLEY Z�P �°�432
Section No. Township Name or No. Range No. Fire No. County ANOKA
OccupaM Phone No.
YALAI ZHAt�G 785-0808
Power Supplier Address
NSP l4PLS OF'FICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
MASTER ELECTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE MN. 55378
Authorized Signature (Contractw or Owner Performing Installation) Phone No.
9 1 7 ! —
EB-OOOOtA-11 8/95 STATE BOARD COPY - SEE INSTRU IONS O BACK OF YELLOW COPY