P - 83071REGIUEST FOR ELECTRICAL INSPECTION
IIIII� I�II� I�I�I (III� IIIII �I�II (IIII I�I�I (III II�I 1ng21eUn versty A earRmf SI 128cSt. Paul, MN 55104
'* 0 3 8 6 9 4 8 4�` Phone (612) 642-0800
Home Duplex Apt. Bldg. Other: New
Commercial Industrial Farm Remc
Air Cond. Htg. Equip. Water Htr. oad Mgmt. Other:
Dryer Range Elec. Heat emp. Service
above the work covered by this request. Enter remarks in this space and on the t�ack of the whrte co�y only.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This InspeCtion Request will not be accepted without the correct fee:
Other Fee # Service Entrance Size Fee # Circuits/Feeders
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Amps Above 100 Amp
Transformer/Gerierator INSPECTOR'S USE ONLY TOTAL
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
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"�;?,� �
Addn
Repair
Fee
own i u i m iy r I hereby certify that I inspected the elecirical installation described herein on the dates stated
Irrigation Bo Rough-In Date
pecial Inspection Q
Investigative Fee ��� � � 'Z °' %/
THIS INSTALLATION MAY BE ORDERED DISC NECTED IF NOT COMPLETED WIT IN 18 MONTFlS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
386-948� • l5 �
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PLEASE PRINT OR TYPE JCiB Ht1MBER �970600
Request Date Rough-in inspection required? ❑ Yes ❑ No Inspection Other Than Rough-In: ❑ Ready Now ❑ Will Call
$/ i 4/ 98 (You must call the inspector when ready) X Date Ready: X
I, ❑ Jice�sed contractor ❑ owner hereby request inspection of the above electrical work at:
X
Job Address (Street, Box, or Route No.) City Zip Code
Section No. Township Name or No. Range No. Fire No. County
Occupant Phone No.
Power
(Company Name)
n
r
Master Lic. No. (Plant Elect. Ony)
Phone No.
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTtONS ON BACK OF YELLOW G� S—�i % 12 i 8�0 — 3SS S