P - 83709� � REGIUEST FOR ELECTRICAL INSPECTION �
I '� I II�II��III IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII 1n821eUni eSs ty Ave. rRmf SI 128cSt. Paul, MN 55104 �`q, �_��
* 0 3 6 3 8 9 4 7* Phone (612) 642-0800 �"�"�'
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 SWITCH INSTALLATION
Calculate Inspection Fee - This Inspection Request will not be accepted without the conect tee:
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 TOTAL o �
Sign/Outline Ltg. Xfmr. 15.
Alarm/Remote Control
SWIf711'Tllllg POOI - I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
}C Speciallnspection i . 00
Final -� � � —
Investigative ►"' __--��-- — - `Z�— ��
THIS INSTAL A I A BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN_18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-894�] � �� 8� �,
�`�"sb JOB NUMBER �9706000
PLEASE PRINT OR TYPE
Request a� 1 � 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, }� licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address Street, Box, or Route No.) Cit Zip Code
0034�'l RICE CREEK TER NE F�tIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
RONALD D NEUS 572-1264
Power Supplier Address
Ngp !lPLS OFFICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only)
MASTER ELECTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S.SAVAGE MN. 55378 I
Authori Signatu (Contr to or Owner Performing Installation) Phone No. ,
'"' 941 4712/890-3555
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY