P - 83702,� I�I� IIIII (IIII IIIII IIIII IIIII IIII) IIIII IIII IIII M82�1 U�niverstyO B eLRm. SR1C8, StN aPEMN ION04
* 0 3 6 3 9 3 5 8* Phone(612)642-0800
Home Duplex Apt. Bldg. Other: New
Commercial Industrial Farm Remc
Air Cond. Htg. Equip. Water Htr. X Load Mgmt. Other:
Dryer Range Elec. Heat Temp. 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
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Repair
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 ONLY TOTAL r�.F'i
Sign/Outline Ltg. Xfmr. 1 ''�J.�m
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In oace
}C Speciallnspection 1 . 0Q1
Final Date
Investigative ��----� � � — �
THIS INSTAL A O E ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
- OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-935
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JOB NUMBER #�9706000
PLEASE PRINT OR TYPE
Request9alE1"f �[�'�' Rough-in inspection required? ❑ Yes �Jo Inspection Other Than Rough-In: � Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: '� � 1^f � 9'�
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
00149 PILOT AVE F'RIDLEY 55421
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant
BETH RAUSCH
Power Supplier
Electrical Contractor (Company Name)
Phone No.
SANOBERG
Address
MPLS OFPICE
Contracior License No.
Mailing Address (Contractor or Owner Performing Installation)
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Author Signat re ( ontractor r ner P rforming Installation)
EB-00001A-11 8/95 STATE BOARD COPV - S IN
571-3296
ON BACK OF YELLOW COPV
Master Lic. No. (Plant Elect. Only)
Phone No.