P - 83696I IIIIII�III IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII
� *03638723*
Home Duplex AF
REQUEST FOR ELECTRICAL INSPECTION �°'E�
Minnesota State Board of Electricity �� �'`
1821 University Ave., Rm. S-128, St. Paul, MN 55104
Phone (612) 642-0800 �`�'�� �a
Other:
New Addn
Commercial Industrial Farm Remod °°^'
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
X" above the work covered by ihis request. Enter remarks in this space and on the back ot the white cqoy 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 Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200_Amps Above 100 Amps
Transformer/Generator INSPECTOR'S USE ONLV TOTA�S �
Sign/Outline Ltg. Xfmr.
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
Special Inspection • , �
Final � �a G . �
Investigative F
_ THIS INSTALLA I _ A __ ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
� OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-872�]
� ��38d �
�5�� JOH NUMBER #�9706000
PLEASE PRINT OR TYPE
Request Rough-in inspection required? ❑ Yes o Inspection Other Than Rough-In: Ready Now ❑ Will Call
(You must cail the inspector when ready) Date Ready: 7� 17 � 97
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
�o�n�d�5��treet,Box,o�����N AVE NE ��tIDLEY Z"��432
Section No. Township Name or No. I Range No. I Fire No. I County ANOKA
Occupant Phone No.
KEITH J MAAHS 586-0587
Power Supplier Address
NSP MPLS OFFICE
Electrical Contractor (Company Name) Contractor License No.
MASTER ELECTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 $OaNE AVE S. SAVAGE MN. 553'78
Authori Signa r Contract r o wner Performin t t �
�� � `.f 941 •
:-OOOOlA-11 8/95 STATE BOARD COPY - SEE WSTRUCTIONS ON BACK OF YELLOW COPY
Master Lic. No. (Plant Elect. Only)
Phone No.
4712/890-3555