P - 81354. jll��l II I I I II II I I I II) I I III II ME n�esota S atOe eoard of ERentAc tyNSPECTION �,.p��t
� � 1821 University Ave., Rm. S-128, St. Paul, MN 55104 ��.�•�'�
* 0 3 9 2 4 1 2 3* Phor,els�z�saz-oaoo
Home Duplex Apt. Bldg. Other: New Addn
4ir Cond. Htg. Equip. Water Htr. �( load M9mt Other.
�ryer Range Elec. Heat Temp. Service
above the work covered by fhis iepuesC Enter rema�ks in fhis space and on the back of fhe whi[e copy only.
SAVEk'S SWITCH INSTALLATIO}S
ulate Inspection Fee - 7his Inspection Request will not be accepfed without the covect (ee:
Other Fee � Service Enlrance Size Fee � Circuils/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Sheet Ltg./Traffic Sig. Above 200_Amps Above 100_Amps
Transformer/Generator INSPECTOR'$USEONLV TOTAL
Sign/Outline Ltg. Xfmr.
Alarm/Remote Conhol
50
ihat I inspecled Ne elecUical Inebllatlon tlescribed herein on ihe de�es statatl
�ate
K Special Inspection 1• 50 F, ai o�iE
Investigative Fee - .� b' � f
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 78 MONTHS.
OFFICE USE ONLV This repuest voitl 18 months fmm valitla�ion daYe prin�etl in this box.
392-41 a�] �a65 ��,
IOB NUMHEk #�y06@N�
PLEASE PRINT OR TYPE
Reque�t �ifF 3� � C�$ Rough-in Inspedion requiretl? 0 Ves Q�o Inspection Other Than Rough-In: � Ready Now 0 WII Call
�Yw musl call me inspector when reatly) Date Reatly: � 1�-.��� 98
I, � Ilcensetl contractor ❑ owner hereby request lnspection of the above electrical work at
Job Atldress (SVee1 Boz, or Faute Nu7 Clry Lp Code
01270 NOftTON AVE NE FRIDLEY 55432
Section No. Township Name or No. R2nge Na Fire Vo. County
ANOKA
Ocwpent - Phone No.
SILL D WILDES 5�1-3243
Power Supplier Address
H�P MPL.S OFFICE
Elec[rical Gonlrector (COmpacy Name) pontractor Licerise No. Mestor Ga No-(Plant EIecL Only)
MASTER ELECTRIC CO.,INC. CA01192
Malling Pddreas (COnhacror or Owner Perlorming Installatior)
� r manzeo ognawre ��onvacior �wnet Yertorming InGalla�ion) ��}�[� {>
V �V
941
E8-00001A-11 8i95 STATE BOARD COPV - SEE MSTRUCTIONS ON BACK OF YELLOW COPY