P - 84083' I � REQUEST FOR ELECTRICAL INSPECTION ��
I II��II�IIII IIIII IIIII IIIII IIIIIIIIII IIIII IIII III� 1^821 Univess ty A earRmf SI j 28ciSt. Paul, MN 55104 �,�����
r Phone (612) 642-0800 �`°_'
*03716859*
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. 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 SWITGH INSTALLATION
Calculate Inspection Fee - This Inspection Request will not be accepted without the 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 ONLV 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 Bbom J Rough-In Date
Special Inspection �
Final � ��L t-�—� D � Z� �
Investigative Fee
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS. __
�._—��—.w_�_ -------------------------------
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
371-685 [� /���--�
������ JOB NUMBER #9706000
PLEASE PRINT OR TYPE
Reque�f�a,el'� � Cj� Rough-in inspection required? ❑ Yes [�lo Inspection Other Than Rough-In: � Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: 10 � 1'7 � 9%
I, �] licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
�019V1 RICE CREEK TER NE FRIDLEY 55�32
Ser.tion No. Township Name or No. Range No. Fire No. County
Occupant
MARIAN REJMAN
Power Supplier Address
NSP MP
Electrical Contractor (Company Name)
MASTER ELECTRIC CO.,INC.
Mailing Address (Contractor or Owner Performing Installation)
or Owner Performing
ANOKA
Phone No.
574-7518
Contractor License No.
CA011'32
EB-00001�8/95 STATE BOARD COJ�►/-�E iN$T�iITC�IONS ON BACK OF YELLOW COPY
/ �-% h,,,
Master Lic. No. (Plant Elect. Only)
Phone