P - 83419� I"IIII�I�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 1^82�1 U�iverst0 Be R� SR1C8 S[ PaPEMNION04 ����.
* 0 3 7 8 8 8 4 1 * Phone (612) 642-0800 ����•�
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" above the work covered by this request. Enter remarks in this space and on the back of the white copy only.
SAVER'S SWITCH ITISTALLATION
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
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming Pool
Irrigation Boom
Speciallnspection 1;
Investigative �
THIS INSTAL A IV
• � • �
. ..-
15. 5Q
I hereby certify that I inspected the electrical installation described herein on the dates stated
Rough-In Date
1 Final � I Da� ��1
_ .��c� a -- z z ,
ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 moMhs from validation date printed in this box.
� y/� � `�
JOB NUMBER �t9706000
PLEASE PRINT OR TYPE
Reques��Z 6� 98 Rough-in inspection required? ❑ Yes [hNo Inspection Other Than Rough-In: � Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: �� ��� GA
I, �] licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
01�56 FILLMORE CIR FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant
Phone No.
MARLYN B BARBER
Power Supplier Address
NSP MPLS OF'FICE
Electrical Contractor (Company Name) Contractor License No.
MASTER ELE�TRIC CO. INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
Master Lic. No. (Plant Elect. Only)
A or ed Signature (Contractor or Owner Performing Installation) Phone No.
�6
EB-OOOOtA- 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY