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*03869856*
REQUEST FOR ELECTRICAL INSPECTION ���
Minnesota State Board of Electricity �� °i
1821 University Ave., Rm. S-128, St. Paul, MN 55104 �_
Phone (612) 642-0800 ��`"�' ��`
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. oad Mgmt. Other:
Dryer Range Elec. Heat emp. Service
"X" above the work covered by this request. Enter remarks in this $oace and on the back of the white copy only.
SAVER' S S4IITCH IHSTALLATIOht
Calculate lnsoection Fee - This Inspection Request will 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.JTraffic Sig. Above 200 Amps Above 100 Amps
TransformerlGenerator INSPECTOR'S USE ONLV TOTAL 15. �0
Sign/Outline Ltg. Xfmr.
Alarm/Remot tr I
SWIf1lfTllflg P I hereby ceAify that I inspected the electrical installation described herein on the dates stated
I rigation Boom Rough-In �ate
peciallnspection � Finai Dat
Investigative Fee _e.-1 � % �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE OtJLY This request vad 18 months from validation date printed in this box.
386-985� � �s �
u� �'
JOB NUMBER #9?0600
PLEASE PRINT OR TYPE
Request Da Rough-in inspection required? � Yes ❑ N inspection Other Than Rough-In: ❑ dy Now ❑ wll Call
(You must call the inspector when ready) Date Ready: �I 1'4I98
I, ❑ licensed contractor ❑ owner hereby request inspection of the above electrical work at:
''°`' A���' �,, B°", °� R%��i�ODY DR NE c�t'�'R I DLEY Z�p `�5432
Sec[ion No. Township Name or No. Range No. Fire No. County AHOKA
Occupant Phone No.
30SEPH P SHRAKE 784-5253
Power Supplier Address
NSP MPLS OFFICE
Electrical Contractor (Comparry Name) Contractor License No. Master Lic. No. (Plant Eled. Only)
MASTER ELECTRIC CO.,IKC. CA01192
Mailing Address (Contraetor or Owner Performing Instailation)
12467 BOONE AVE S.SAVAGE MN. 55378
Authorized S' n (Contractor or Owner Perfaming Installation) Phone No.
c �;� 94 —4712/890-355
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF VELLOW COPY