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* 0 3 6 3 9 8 6 1 �` Phone (612) 642-0800
Home Duplex Apt. Bidg. Other: New
Commercial Industrial Farm Remc
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above the work covered by this requesf. Enfer rema�ks in this space and on the back of the white copy only.
SAVER'S SWITCH INSTALLATION
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Addn
�ulate 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 ONLY TOTA}5 ���
Sign/Outline Ltg. Xfmr.
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 ' -
Final � D �.,
Investigative �'+ �" �.z:,�
THIS INSTALLATION Y E ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-986 � .,� �� �� �
�5'� � 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%� 9%
I, u licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route NoJ Cit Zip Code-
00281 RICE CREEK TER NE F�?IDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
CARL ZUK 571-4150
Power Supplier Address
NSP MPLS OFFICE
Electrical Contractor (Company Name) Contractor License No.
liASTER ELECTRIC CO. , INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S.SAVAGE MN. 55378
Master Lic. No. (Plant Elect. Only)
Authouzad Sionatdre (Contractor or Owner Perfor i In tallation) � Phone No.
EB-00001A-11 8/95
� � � � �' 941 � 4712 / 890 - 3555
STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY