P - 83150, i' REC,IUEST FOR ELECTRICAL INSPECTION �
,�616 ��� O � 8121 Univers ty A ear Rm. S-128, ISt. Paui, MN 55104
�
Phone(612)642-0800 " '
g Home Duplex Apt. Bldg. Other: X New Addn
Commercial Industrial Farm Remod Re air
Air Cond. X Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above the work covered by this request. Enter remark in this space and on the back of the white copy only.
Furnace, Kitchen exhaust fan, humidifier, reconnec>
Calculate lnspecfion Fee - This lnspection Request wil! not be accepted without ihe correct fee:
Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200.:Amps 0 to i00 Amps
Street Ltg,/Traffic Sig. Above 200 Am s Above 100 Amps
Transformer/Generator INSPECTOR'S USE ONLY TOTAL
Sign/Oudine Ltg. Xfmr. i.,�� ` 15 . 50
Alarm/Remote Conhol � �� �, V
Swimming Pool
I hereb certi that I ins ted the elecfrical insfallation described herein on the dales sfoted
Irri9ation Boom Rougf�ln Dare
Special Inspection
F,�npl Date
Imestigative fee - Z —2 p"'Q �
TH1S INSTALLATIOIY MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHlN 18 MONTHS. .
�� OFFICE USE ONLY This request void 18 monfhs from validation date printed in this box.
II�II(IIII11111111II11 IIIIIIIIII • �s�
IIIIIII�
* 0 6 1 6 2 3 0 9* tz�o(�� ��.34
PLEASE PRINT OR TYPE
Requesf Date Rou h-in ins fion r uired$ [] Yes
4-14- 9 8 9 P� eq � No inspection Other Than Rough-In: � Ready Now � Will Coll
�You must call the inspector when ready) Date Ready:
I, $] licensed controctor ❑ owner hereby request inspection of the above electrical work at;
Job,Address (Sheef, Box, or Route No.) Cily Zip Code
6558 Oakley Dr NE Fridley Fridley 55432
Section No. Township Name or No. Range No. Fire No. County
Anoka
Occupanf Phone No.
Mike Flan 574-0134
Elechical Conhactor �Compony Name�
Total Electric, Inc.
Mailing Address (Contracror or Owner PerForming Insiallation)
1537 92nd Ln NE Blaine MN 55449
Authorized natore �Confrador. or Owner Pe�g Installafion) I Phone No.
786-8484
BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
�hacfor License No. I Masfer Lic. No.
CA02749