P - 82918RE(�UEST FOR ELECTRICAL INSPECTION
6 C��� O C Minnesota State Board of Electricity
•�.3 J 1821 University Ave., Rm. S-128, St. Paul, MN 55104
� C I T Y Phone (612) 642-0800 3
X Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Re air
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.
TM3662 — INSTALL SUBPANEL — WIRE TO POOL & POOL LIGHT.
Calculate Inspection fee - ihis 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./Tra(fic Sig. Above 200 Am s Above 100 Amps
Transformer/Generator INSPECTOR'S USE ONLY TOTAL 4 �. 5�
Sign/Outline Ltg. Xfmr.
iQlarm/Remote Conhol
imming Pool
I here certi that I ins the el 'cal installafion described herein on the dates sfated
Irrigation Boom RoogMo 4� D ' Z� �
Special lnsp
Final .- Z �
Investigative e
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
I�� II I`) II III II III II OFFICE USE ONLY This request void 1& m� from validation date printed in fhis box.
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* 0 6 5 2 5 0 5 9* ���Q
PLEASE PRINT OR TYPE
Request Date Rouglfin inspection required2 �] yes ❑� No Inspecfion Other Than RougMn: ❑ Ready Now � Will Call
6/ 12 / 9 8 (You musf call the inspecFor when ready) Date Ready:
I, � licensed contractor ❑ owner hereby request inspection of the above elecfrical work at:
Job Address (Sheet, Box, or Route No.� City Zip Code
7115 RIVERWOOD DR. FRIDLEY 55432
Secfion No. Township Name or No. Range No. Fire No. County
ANOKA
Occupanf Phone No.
JIM FELTON RESIDENCE
Power Supplier Address
ANOKA ELEC.
E����M U S K A�� E L�� C T R I C C 0 M P A N Y c�C A 012 8 7 �'1°ster Lic No. (Plant Elect. Only)
Mailin 1A9 855c�0 A K C R E S T�A�%�E �������� R 0 S E V I L L E,�M N 5 51 13
Authorized Signature �Confracror or Owner Performing Insfallalion) e�� r-' Phone No.
tj � 636-5820
EB-00001 A-11 8/96 STATE BOARD COpY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY