P - 83704I II�I�� �I IIII) IIIII (IIII IIIII IIIII IIIII III) IIII 1�82�1 U�niverst0 B e LR � SReC8 StN SPEnCN ION04
* 0 3 6 3 3 2 2 9* Phone(612)642-0800
Home Duplex Apt. Bldg. Other: New
Commercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr. X Load Mgmt. Other:
Dryer Range Elec. Heat emp. Service
;" 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
Calculate Inspection Fee - This Inspeciion Request will not be accepted without the correct fee:
Other Fee # Service Entrance Size Fee # Circuits/Feeders
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200_Amps Above 100 Am
����_
-� m'�?;�. �
Addn
Fee
Transformer/Generator INSPECTOR'S USE ONLY TOTAL , S 0
Sign/Outline Ltg. Xfmr. 15. �
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
}� Speciallnspection i . 00
Final
Investigative � Ci'' �
THIS INSTALLATIO E ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 8 MONTHS.
� OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-322�] �. ���
/�iV`�� JOB NUMHER �9706000
PLEASE PRINT OR TYPE
Request a� Rough-in inspection required? ❑ Yes o Inspection Other Than Rough-In: Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: ?� 1'7 � 9'7
I, u licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
06251 RAINBOW DR NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
JOHN A JACOB 574-0118
Power Supplier Address
NSP MPLS OF'FICE
Electrical Contractor (Company Name) Contractor License No.
MASTER ELECTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE KN. 55378
Authoriz�Signat. (ContraSy.b�r Owner Performing Installation)
8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
Master Lic. No. (Plant Elect. Only)
Phone No.