P - 84609� REQUEST FOR ELECTRICAL INSPECTION
4��F -16 9 Minnesota State Board of Electricity
1821 University Ave., Rm. S-128, St. Pa I, MN 55104
Phone (612) 642-0800 C I TY '�(% j�
Home Duplex Apt. Bldg. Other: New
.. �:-;�,
K-"-v�a
;
�,.....:)1.,..... ,
Addn
Commercial Indushial Farm Remod X R
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above ihe work covered by this requesf. Enter remarks in this space and on the back of the whiie copy only.
TM3218 — INSTALLATION OF (3) 8' LIGHTS ONCEILING OF
CONF. RM. CONTACT DUANE HEIDEN AT MAIN BAKERY.
Calculate Inspection Fee - This Inspection Request will not be acc�
Other Fee # Service Entrance Size
Mobile Home Park Stall 0 to 200 Amps
Street Ltg./Traffic Sig. Above 200 Am
Transformer/Generator INSPECTOR'S USE ONLY
Sign/Outline Ltg. Xfmr.
Alarm/Remote Conhol
Swimming Pool
wi►hout the correct fee:
Fee # Circuits/Feeders Fee
0 to 100 Amps
Above 100 Amps
TOTAL 20.50
I hereb certi that I ins ed ihe elechical installafion dexribed herein on the da
Irrigafion Boom RougMn pare
I Investigafive FeA�I f� „�,� Q� �...�� � ��� 17' j� l�'`�
��
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFF7CE USE ONLY This request void 18 months from validation date printed in this box.
r� ��
��������������������III�II������������������������ � �o . 5--�
* 0 4� 4]� 6 9 0* PLEASE PRINT OR TYPE ���
Request Dafe Rou h-in ins ion r uired?
6/ 6/ 97 9 � � ❑ Yes � No Inspeclion Olher Tfjyq I�o�qfy�r�: �� Ready Now 0 Will Call
(You must call the inspeclor when ready) Date Ready: �� � I U/�
I, [�licensed conhactor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Streef, Box., or Route No.� City Zip Code
5735 MAIN STREET FRIDLEY 55421
Section No. Township Name or No. Range No. Fire No. County
ANOKA
���Pa^� Phone No.
MCGLYNN'S DEKO PAK
Power Suppiier Address
NSP
Elechical Conhactor (Company Name) Conhocfor License No. Master Lic. No. (Planf
MUSKA ELECTRIC COMPANY CA01287
�;�������SS�o���o���,,e����5roua�o�SEVILLE, MN 55113
o.
�
��
0
�