P - 84085� � REQUEST FOR ELECTRICAL INSPECTION � °":e�;
' � I�����IIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIII 1n821eUni eSsty A earRmf SI 128cSt. Paul, MN 55104 ��.��
* 0 3 7 1 6 8 7 5* Phone (612) 642-0800 -'T'
Home Duplex Apt. Bldg. Other: New Addn
Remod Repair
Commercial Industrial Farm
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 ot the white copy only.
SAVEk'S SWITCH 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 ONLY TOTAL
15. 50
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimmin Po °
g �� � '' I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
Speciallnspection Final
Investigative Fee • ^ � L ��
R_ THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
' 4 OFFICE USE ONLY This request void �8 months from validation date printed in this box.
371-687 [�
,� ���9�"
�5 �
JOB NUMBER #9706000
PLEASE PRINT OR TYPE
Requ�t�atel `� � Cj7 Rough-in inspection required? ❑ Yes �lo Inspection Other Than Rough-In: [� Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: 1@ I 1% I 9%
I, U licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
00?iQ► RIC:E CREEK TER NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANaxA
Occupant
IRFAM KH
Power Supplier
AND02I
Address
Electrical Contractor (Company Name)
ttASTER ELECTRTC CO. , Ir
Mailing Address (Contractor or Owner Performing Installation)
or Owner Performing Installation)
Phone No.
� n��rr-E
Contractor License No.
S/95 STAT�'`$Q�i��(�P�l`�EE INSTRUCTIONS ON BACK OF YELLOW COPY
Master Lic. No. (Plant Elect. Only)
Phone No.