P - 84084III�II�IIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIII 1n82�1�U�iverstyOAve.LRm. SReC8cStNS PEnCNION04 � ���
0371 6552 �� �
� * * Phone (612) 642-0800 ��'
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
X" above the work covered by fhis request. Enter remarks in this space and on the back of the white copy only.
SAVER'S SWITCH INSTALLATION
Calculate Inspecfion Fee - This Inspection Request will not be accepted without the correct fee:
Other Fee # Service Entrance Size Fee # Circuits/Feeders
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Amps Above 100 Am
Fee
Transformer/Generator INSPECTOR'S USE ONLY TOTAL
Sign/Outline Ltg. Xfmr. 1S. 50
Alarm/Remote Control
Swimming Po '� �" - `'
I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
Special Inspection
Final � e D _ �7 .z_ ��
Investigative Fee '—��_ . �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
371-655 [2� ��� �
���� " � JOB NUMBER #9706000
PLEASE PRINT OR TYPE
Reque�t�a�21'7 � C�^J Rough-in inspection required? ❑ Yes [�Jo Inspection Other Than Rough-In: � Ready Now ❑ Will Call
(YOU must call the inspector when ready) Date Ready:
I, �] licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
00�85 RICE CREEK TER NE FRIDLEY 55432
'�, Section No. Township Name or No. Range No. Fire No. County
Occupant
ROGER W
Power Supplier
NSP
Electrical Contractor (Company Name)
Mailing Address (Contractor or Owner Performing
KAYE
Address
(Contractor or Owner Performing Installation)
ANOKA
Phone No.
571-5712
Contractor License No.
8/95 STATE �A�Cji1P��E� INSTRUCTIONS ON BACK OF YELLOW COPY
�✓
Master Lic. No. (Plant Elect. Only)
Phone No.