P - 84088IIIIII IIIII IIIII IIII) IIIII IIIII IIIII IIIII IIII IIII
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REQUEST FOR ELECTRICAL INSPECTION
Minnesota State Board of Electricity
1821 University Ave., Rm. S-128, St. Paul, MN 55104
Phone(612)642-0800
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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 fhe work covered By this request. Enter remarks in this space and on the back of ihe white copy only.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This Inspection Requesi will not be accepted wiihout 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 ONLV TOTAL
Sign/Outline Ltg. Xfmr. 15. 50
Alarm/Remote Control
Swimming Po "� �'� .� I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boo Rough-In Date
X Special inspection 1. 50
Final Da
Investigative Fee � -�s^ �j
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.
371-635 � /�', �
��(p'���r JOB NUMBER #9706000
PLEASE PRINT OR TYPE
Requ�t�afe 17 ��7 Rough-in inspection required? ❑ Yes [�Jo Inspection Other Than Rough-In: j� 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
01541 S BAVARIAN PAS FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
BETTE JO FRIED 574-0079
Power Supplier Address I
NSP MPL� OFPICE
Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only) I
KASTER ELECTRIC CO. IHC. CA 92
Mailing Address (Contractor or Owner Performing Installation)
Auth iz Si nature (Contractor or Owner Performing Installation) Phone No. I,
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EB-000 A- S/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY I