P - 83695� REQUEST FOR ELECTRICAL INSPECTION �'°'.E
I I�III IIIII IIIIIIIIIIII�II IIIIIIIIIIIIIIIIIII IIII 1ng21eUni eSsateA oarRlof Sle 28cSt. Paul, MN 55104 � 0- �«.
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Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. X Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above the work covered by this request. Enter remarks in this space and on the back of the white copy only.
SAVER'S SWTTCH IHSTALLATION
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 Am
Fee
Transformer/Generator INSPECTOR'S USE ONLY TOTAL ps'O
Sign/Outline Ltg. Xfmr. 15. �@
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
� Y RnPCial Insnection � . 00 te
Investigativ ae
� THIS INST _ lSQ
363-279 �]
Final '
`'�-. — - d , l � . f,
BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
� �38�
�'�'S� JOB NUMBER �97@6000
PLEASE PRINT OR TYPE
Request�a� 17 � R3^� Rough-in inspection required? ❑ Yes �Jo Inspection Other Than Rough-In: [� Ready Now ❑ Will Call
(You must cal� the inspector when ready) Date Ready: '� � '� � 9"f
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
01400 H INNSBRUCK DR FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County �
ANOKA
Occupant
DAVIO RICHARD FERRIER
Power Supplier Address
Electrical Contractor (Company Name)
or
Phone No.
Contractor License No.
572-9138
t WV
1A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
Master Lic. No. (Plant Elect Only)
Phone