P - 83711'I I���II IIIII IIIII IIIII IIIII IIIII IIIII (IIII IIII IIII M8 � U° ae saO B e R� SRe 8 StNS PEMN ION04 �����:
Y � ,
* 0 3 6 3 9 1 4 3* Phone (612) 642-0800 ���� l�
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 emp. 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 In�oection 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 TOTAL5=
Sign/Outline Ltg. Xfmr. 1
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the datesstated
Irrigation Boom Rough-In Date
Speciallnspection •
Final � D ^
Investigative Fee � �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
,_....,�,.r..._.._---___�-________.___---------- ----- - - _
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-914�] �
� �3��
��"s� JOB HUMBER �9706000
PLEASE PRINT OR TYPE
Request 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% I9%
I, }� licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No. Cit Zip Code
04941 ROMA�I RD F�?IDLEY 55421
Section No. Township Name or No. Range No. Fire No. County
AHOKA
Occupant Phone No.
ROL.LAND R POGREBA 572-8691
Power Supplier Address
NSP [iPL.S OFFICE
Electrical Contractor (Company Name) Contractor License No. Master Lia No. (Plant Elect. Only)
MASTER ELECTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVB S. SAVAGE MN. S537B
Authori d ignatu (Contracior r Owner Performing Inst i� �"� Phone No. I
`� 941 4712/890-3555
EB-OOOOtA-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY