P - 81359•� III�II�) II I III II III I II) I III I(IIII M8 � UoSe sa0 B a R� SRtCB St PaPEMNI0N04 ����
* 0 3 9 2 3 0 1 8'F Phone (612) 642-0800 '�`��^�
Home Duplex Apt. Bldg. Other New Addn
ia. ntg. tquip. water Htr. ;S �oad Mgmt pther:
Range Elec. Heat emp. Service
the wak covered by this request Entel remaiks in Ihis space axl on the back o� the white copy wrry.
SAVER'S SWITCH INBTALLATICiN
fnspection Fee - This )nspcctian ReGUest wB) not be acceptetl with0ut the correct tee:
Other Fee n Service Entrance Size Fee � Circuils/Feeders Fee
le Home Park Stall 0 to 200 Amps 0 to 100 Amps
:t Ltg./Traffic Sig. Above 200_Amps Above 100,Amps
�formedGenerator INSPECTOR'S IISE ONLY �TOTAL _
Sign/Outiine Ltg. Xfmr.
Alarm/Remote Gontrol
. 50
"""""""y' 1 M1ereby oertify fi21 I Inspectetl [M1e eleGrioal Insbllallon desuibetl hereln IXI ihe dates stated
Irrigation Boo aouqn-i� oate
u c, � i i t r �' rn
Investigative Fee F��ai /� //��� `1_�oa�e / � `/�
L �C 4�
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request wid 18 months hom valitlation tlate printetl in [his box.
392-301�] ,�� � �v
.�as rauMbsr� u�,smE�c�r�m
PLEASE PRINT OR TYPE
Requs�t�e}e09 � g� Roug�-in inspection tequiretl4 0 Ves �JO Inspxtion O�herthan Rough-In: j� Reatly Now 0 Will Gall
f1'ou must caII1M Irispec[or wM1en �eady) Date Ready: � 1 f�9 � t-��
I, $] licensed contractor ❑ owner hereby request inspection of the above electrical work at
Job Atltlress �Street, Boss. ar Houte NoJ Gty Zlp Gotle
��s1�162 kZCE CREEK kD NE FRIDLEY JJ1I��
Section Na Tovmshi0 �� or Na. Renge Na. Flre Na Cwnty
ANOKA
Occuparrt
HERBERT W IIT
Powor Suppller
Mailirg
Name�
or Owrer
57
Meeler Ga-NO. �Flant Elect.
Phone
EB-00001A-11 8,'g5 STATE BOARD COPY - SEE INSTROCTIONS ON BACK OF VELLOW COPY + `� v� �
i