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Home Duplex Apt. Bldg. Other: �'1� �c New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat emp. Service
"X" above the work cove�ed by this request Enter remarks in this �vace and on the back of the white copy only.
SAVER'S SWITCH IHSTALLATION
Calculate Insoection Fee - This Inspection Request will not be accepted without the cor�ect 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 TOTAI�,��
Sign/Outline Ltg. Xfmr. /
Alarm/Remote I
Swimming Poo 1 hereby certiy that I inspected the elec[rical installation described herein on the dates stated
Irrigation Boom Rough-In Date
Speciallnspection '
Final Date
Investigative Fee
TFfiS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHI 18 ONTH .
OFFICE USE ONLY This request w� 18 months from vaGdation dafe printed in this box.
380-433� �
/� �� �������
JOB NUMBER �i9706000
PLEASE PRINT OR TYPE
Request t Rough-in inspection required? ❑ Yes ❑ Inspection Other Than Rough-In: Ready Now ❑ Will Call
(You must call the inspecta when ready) Date Ready: 7� 07198
I, licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job��.cs�eet, Box, or��,,t�r�bY DR NE �' R I DLEY Z�P �°�432
Section No. Township Name or No. Range No. Fire No. Counfy AH�KA
�`�iSSELL L PETERSON P�neNo. 784-9085
Power Supplier Address
NSP ltPGS OFFICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
MASTER ELECTRIC CO.,INC. CA01142
Mailing Add2ss (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE 1'tN. 55378
Authoriz ure (Contractor or Owner Performing Installation) Phone No.
�,�j' 941 4712/890-3555
EB-00001A-11 8l95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY