P - 831556�.6-236 �
X Home Duplex
Commercial Industric
Air Cond. g Htg. Eqi
Dryer Range
"X" above the work covered
Furnace T Stat
REGIUEST FOR ELECTRICAL INSPECTION
Minnesota State Board of Electricity
1821 University Ave., Rm. S-128, St. Paul, MN 55104
Phone (612) 642-0800 '�'
Apt. Bldg. Other: New Addn
Farm Remod Re air
Water Hh. Load Mgmt. Other:
Elec. Heat Temp. Service
this request. Enter remarks in ihis space and on the back of the white copy only.
Calculate Inspection Fee - This Inspection Requesi 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 Am s Above 100 Ar
Transformer/Generator INSPECTOR'S USE ONLY TOT�
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control �� n Cj 1
Fee
�
��� ����������� ��`�� I hereb certi thaf I ins the eleckical insfallafion described herein on the dates stated
Irrigation Boom RougMn oar�
Special Inspection
Investigative Fee F�ct— D 2_ 2�-'��
HiS INSTALLATION MAY_B€_ORDERED TED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This requesl void 18 months (rom validation date prinfed ir this box.
I IIII II III II �II �I II� �I II �
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* 0 6 1 6 2 3 6 6� 2��`�� � 5�
aac �
PLEASE PRIPtT OR TYPE
Requesf Dafe Rou h-in ins
g pection,required� ❑ Yes �No Inspection Ofher Than RougMn: �Ready Now 0 Will Call
4-23-98 �You musf call thennspector when ready) Date Ready:
I, �] licensed contractor ❑ owner hereby request inspection of the above elecfrical work at:
1ob Address �Sheef, Box, or Roufe No.) City Zip Code
1546 North Timber Ridge Fridley 55421
Section No. Township Name or No. Range No. Fire No. Ca,�n,
Occupant
John Newell
Power Suonlier
AnO1C3
Phone No.
574-0395
- — ,--...'"_..' ..°.."� I Contraciw license No.
Total Electric Inc. CA02749
Vailing Address (Contractor or Owner Performing Installahon)
1537 �nd Ln NE Blaine MN 55449
u�lorlZEdr � ,��� j�viiuuuu� or vWlfer Yert�Olnnn IncMllni�....1 —
STATE BOARD COpY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY