P - 84081� I! I IIIII IIIII IIIIIIIIII IIIII IIII IIII ME n�esoS S atOe B aLd of ERecCtr��ic tyNSPECTION �,���
IIIfIII�IIIIIII I 1821 University Ave., Rm. S-128, St. Paul, MN 55104 �-�'
` * 0 3 7 1 6 1 7 2* P hone ( 6 1 2) 6 4 2- 0 8 0 0 ��'�''�
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
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
Calculate Inspection Fee - This Inspection Request will not be accepted withoui 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
Fee
Transformer/Generator INSPECTOR'S USE ONLY TOTAL
Sign/Outline Ltg. Xfmr. 15. 50
Alarm/Remote Controt
Swimming Po Y r I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
}{ Speciallnspection 1 . 50 �
Final
Investigative Fee D ^ �
THIS INSTALLATION MAY BE ORDERED DISC ECTED IF NOT COMPLETED WITHIN 18 MONTHS.
'�` OFFICE USE ONLY This request void 18 months from validation date printed in this box.
371-617 [.?� /5.�"0
,�-����'
JOB NUMBER �970600Q1
PLEASE PRINT OR TYPE
Requ�sGQaTE1,7 / 97 Rough-in inspection required? ❑ Yes ❑�jJo Inspection Other Than Rough-In: fal. Ready Now ❑ Will Call
1 I[J / n 7l
(You must call the inspector when ready) Date Ready: � A� � 7 f q7
I, $] licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
06261 FtAINBOW DFt NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
Occupant
RITA A
Power Supplier
DYLE
Address
Electrical Contractor (Company Name)
Mailing Address (Contractor or Owner Performing
or
AxoxA
Phone No.
574-2�68
Contractor License No. I Master Lic. No. (Plant Elect. Only)
8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
Phone No.