P - 84077I I��II�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII R8 Q UESe SFORve.LRm. SRIC8 S{NS PEnCNION04 ����'
� Minnesota State Board of Electricity �
Y
' * 0 3 7 1 6 9 1 7* Phone (612) 642-0800 �''�"�
Home Duplex Apt. Bldg. Other: 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 covered by this request. Enter remarks in this space and on the back of the white copy only.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This Inspeciion Request will not be accepied 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 TOTA1 'rJ. 50
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming Poo !"� � I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom � Rough-In Date
Special Inspection p �� ` �
Final
Investigative Fee
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
371-691 [7� /5, 5�
��lUi�S JOB NUMBER #9706000
PLEASE PRINT OR TYPE
Requ a e Rough-in inspection required? ❑ Yes �Jo I Inspection Other Than Rough-In: �
(You must call the inspector when ready) Date Ready:
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City
01467 H INNSBRUCK DR FRIDLEY
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant
Phone No.
RICHARD J SMITH
Power Supplier Address
NSP MPLS OFFICE
Electrical Contractor (Company Name) Contractor License No.
MASTER EL.ECTRIC CO. INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOOME AVE S. SAVAGE MN. 55378
Authqr+Zeyl,Sigpature (Contractor or Owner Performing Installation)
Ready Now ❑ Will Call
10/17/97
Zip Code
55432
571-0101
8/95 STATE BaAF�[SC�iPi'�S� WSTRUCTIONS ON BACK OF YELLOW COPY
Master Lic. No. (Plant Elect. Only)
Phone No.