P - 84080I,IIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII) R82�1 UEiSersFORve.LRm. SR1C8 SINS PEMNION04 �����
Minnesota State Board of Electriaty �' �
* 0 3 7 1 6 4 4 6* Phone (612) 642-0800 ������
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Hemc
Air Cond. Htg. Equip. Water Htr. X Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above ihe work covered by this request. Enter remarks in this space and on the back of the white copy only.
SAVER'S SWITCH IHSTALLATIOH
ulate Inspection Fee - This In�uection Request will noi be accepied withoui ihe 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
Sign/Outline Ltg. Xfmr. 15. 50
Alarm/Remote Control
Swimming Pool � I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom � Rougn-in Date
Speciallnspection 1 . 50
Final D
Investigative Fee — d�
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
371-644 [� �
����q� �5
JOB AIUMBER #9706000
PLEASE PRINT OR TYPE
Requa61.61at�1.� � 9.� Rough-in inspection required? ❑ Yes ❑�lo Inspection Other Than Rough-In: [� Ready Now ❑ Will Call
1 YJ
(YOU must call the inspector when ready) Date Ready: 10I 1% I 9%
I, �] licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (SKeet, Box, or Route No.) City Zip Code
06120 RAIHBOW DR NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
ROBERT S HARRIS 571-1889
Power Supplier Address
NSP MPI.S OFF'ICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
Mailing Address (Contractor or Owner Performing
or
8/95 STATE BOARD CO�P -�EiN$1]i1�CJfIONS ON BACK OF YELLOW COPY