Loading...
P - 81351II REQUEST FOR ELECTRICAL WSPECTION �? �°) I I) (� I(' III II I III II) II) 821 Uni ess ty A earRmf S-128CSt Paul, MN 55104 ���- * 0 3 9 2 3 b 4 7* Pnor,e �sizJ saz-osoo ��!�� Home Duplex Apt. Bldg. Other: New Addn Commercial Indushial Farm Remod Repair Air Cond. Htg. Equip. Water Htr. X Load Mgmt. Other Dryer Range Elea Heat emp. Service ' above the work coveretl by Ihis request Enter remarks in fhis space 2nd on the back o/ Ihe white copy wly. �AVEk'S SWITGH INSTALLATION kulate lnspection Fee - 7his Inspectirn Request wil! not be acceptetl without fhe covect /ee: Other Fee � Service Entrance Size Fee � Circuits/Feeders Fee Mobile Home Park Stall O to 200 Amps 0 to 100 Amps Street LtgJTraffic Sig. Above 200 Amps Above 100 Amps Transformer/Generator INSPECTOH'SUSEONLV TOTAL Sign/Outline Ltq. Xfmr. 1r1� .9P, °`y' I hereby certify tFat I Inspoctotl 1M1a alectncel Installation tlescribetl hereln on fhe tlates sYVtetl Irrigation Boom ao�yn-i� o,�e j( Speciallnspection 1 -..5� InvestigativeFee F��al –. ° �LU—�y� THIS INSTALLATION MAY BE ORDERED DISC NECTED IF NOT COMPLETED WITHIN 18 MONTHS. OFFICE USE ONLV This requesl void 18 months from valitlation date printetl in [his box. 392-354�] • �� 5 � 30B NUMBER �i9906Q��i�r PLEASE PRINT OR TYPE a�uef �� 3� � 98 aa�gr-ir �mspectan req�ired? p �es p�o ��s��uo� omer Tna� qo�gh-��: [� Readv Nmv p w�� ca�� (YOU musi call �he ins0ector when reatly) Date Reatly: �- I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at'. Job Atltlress (SVeet, Box, or Rou[e No.l City Zip CoCe 0��518 MEI��TER RD FRIDLEY 5:,432 Section No. Township Name or No. Rarge Nn Fire No. County ANOKA Occupant PMrie No. LFNDA L FOBSCHEN 571-5549 PoWar SupPlier qtltlmss HSP MPLS' C�FFICE Elacltical ConUador (COmparry Name) GonVactor Llcense No. Maeter Lk. No. (Plant EIecL Only) MA�TER ELECiFtIL �u.,EFlt�. ��A01i9� Mailln9 Atldress �COn[rdctor or Owner Periwming Installa�ion) Aulhodzed Slgnature IC�nVactor or Owner Periorming I�$yllplbryh �� Phone No- N V �j� � ^c EB-00001A-11 8/95 STATE 80ARD COPV � SEE INSTHUCTIONS ON BACK OF YELLOW COPY