P - 81358. iI�I IIIII I IIII II III I I IIIII II IIII II REaUEST FOR ELECTRICAL INSPECTION ���
Minnesota State Board of Electricity ���s..
1821 Universiry Ave., Rm. S-128, St. Paul, MN 55104 �.
* 0 3 9 2 3 8 1 0* Pnor,efsiz>sa2-oaoo ��'- �
Home Duplex Apt. Bldg. Other: New Addn
id. Htg. Equip. Water H[r. X Load Mgmt. Other:
Range Elec. Heat emp. Service
tRe work coveied by this request. Ente� remaks in this ;oace arrd on fhe 6ack o7 the whife Copy onty.
SAVER'S SWITCH INSTALLATION
lnspec6bn Fee - This Inspection FequeSt wil! rrot be acc�tetl withWt [he conec[ /ez:
Other Fee = Service Entrence Size Fee tt Circuits/Feeders Fee
le Home Park Stall 0 to 200 Amps 0 to �00 Amps
�t Ltg./Traffic Sig. A6ove 200_Amps Above 100_Amps
sformeNGenerator INSPECTOF'S USE ONLV TOTAL
/Outline Ltg. Xfmr. �. SQI
n/Remote Control
ammm�ny r i I hereby certify ihat I Inspectatl �he ekenical lnstallation tlesctlbed herein on �he tlates s�atetl
Irrigation 80 � ) ao�gn-i� oe�e
}{ Special Inspection 1. S(p F;�ai , o�j n
Investigative Fee �-{"—� J
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY T�is reQUest witl 18 monihs �rom valida�ion tlate printed'm �his box.
392-381�] � �5 �
/a 6
JOH NUMHER #9�0600�
PLEASE PRINT OR TYPE
Fequect �ata.�� � 9� Rough-in Inspec�ion requiretl? Q Yes �o Ir�spection Other Than Fough-In� [� Reatly Now � Will Call
2 l
ryw mus� call Me Inspector when reatly) Oa�e Reatly. �
I, � licensed contraCtor ❑ owner hereby request inspection of the above eleCtrical work at
Jub Atltlress (Sheet, 6ox, or Route NoJ Clry Zip Cotle
05653 REGIS TE?L FRIDLEY 55932
Sec�ion No. Township Name or No. Fange No. Fire No. Counry
AT1tJXA
Occupan� Phone No.
MICHAEL J MCMAHON 571-7384
Power Supplier Atltlress
NSP P
Electrioal CorNactor (Company Name) Gonlac\o* Lmeree Pdo_ Master Lb.IJO. (Plant EIeeL Ony)
Mailirg Adtlress (GOnVacter or Owne� Performin9lnsta ation)
I AWhorizetl SgnaWre (COnhacWr or Owner Pertorming Insblle�ion) ��^ I �� I Phorie No.
� x 7 i
lJ y �"�[i � IY i-'ri �
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON B�1CK OF VELLOW WPY