P - 81362V , I�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�I�IIIIIII MgQUEaerstyOAveLRm.TB-1P8,StNSPECNION04 ����y�
' * 0 3 9 2 3 9 5 0* Pno�e �si2� sa2-osoo �:���
� Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. X Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X' a6oVe tAe wo/k cove2d by tli�s /eq(rest Enter remarks in lhis �� and or1 the b3Ck oI the white c�y onty
SAVER'S SWITCH INSTALLATION
ulate Inspection Fee - This lnspecfion Request will not be accep[ed without the coaect fee:
Other Fee n Service Entrance Size Fee � Circuits/Feeders
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Si9. Above 200 Amps Ahove 100 Am
Transformer/Generator INSPEGTOR'S USE ONLY 70TAI
Sign/Outline ltg. Xfmr. ,
_.....,..,.�.7..,e inereev�e
Irriqation Boom aou9a-m
Speciallnspection 1 . 50
Final
Irrvestigative Fee
THIS INSTALLATION MAY BE ORDERED
392-39�.[0�
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mat
me
Fee
\ - �--r�-c„—�'��,- I L ^ / ( ' r /
DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONIY Thie reques[ witl 18 monihs irom valitlation tle�s Orinted In tM1ts box.
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F'LEASEPRINTORTYPE JOB 1dUMBEk #9�j060�PJ
Reque�ipat¢.3���g Rough-iriinspecfionrequirerl?DYes o IrispxtionOlM1arThenRouh-n
i�' � �}N e i�. CK waav Now p wm ceu
IVOU mus[ call the inspettor when reatly) Dale Ready
I, � licensed coniractor ❑ owner hereby request inspection of thg above elecf�ical work aY
Job Atltlress (Strea�, Box or fiQUte No_] ��y
00162 RSVER EDGE WAY NE FRIDLEY zPCOde
55432
Section No. Township Name or No. Ranq� No. Fire No.
County
a��Pam AHOKA
Phooe No.
KRISTIN L REPP 571-3931
Powe� Suppller ,��___
tiecmcal Goniryc�or (COmpary Name) Crntrac�or lkense �.
Mailing qdtlrase �Contrectot or Owner Periwming Ins[al!ytiorp
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Authrrizetl5lgnaNre(ContrectororOwrmrPodomimglnsia118�ion) (� /�
r� U
E9-00001A-11 8/95 STATE 60AR0 COPV - SEE INSTR4�TIONS ON BACK OF YELLOW COPV
Lic. Mo. (Plan�