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Home Duplex Apt. Bldg. Other New Addn
Commercial Industrial Farm Remod Reoair
�ir Gond. Htg. Equip. Water Htr. X Load Mgmt. Other:
)ryer Range Elec. Heat emp. Service
sbove the work covered by this request. Enter remaks in this space a� on the back o1 the white copy ort
SAVER'S SWFTCH INSTALLATION
ulate �nspection Fee - This In;oection Requesf will not be accepfed without the correct /ee:
Other Fee � Service Entrat�ce S�ze Fee x Circuits7Feetlers
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg.fTratfic Siy. Above 200_Amps Above 100_Am
TransformeNGenerator INSPECTOfi'S USE ONLV TOTAI
Sian/Outline Lta. Xfmr. 1
Fee
G-Ls]
OWp11"' �b F��� '� — � I hereby certity'Mat I Inspeotad ihe eiecincal installallon tlosedbetl M1srein on Che tlates s[a[etl
Irngation Boom � ao�yn-�a oaie
Special Inspec}ion • J
F�i�ai oa. C'
InvestigativeFee e. —��� S
THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request miC 1R ��rcm vnlidavicn tlate printed In �pis box.
392-37� i5, �-p
JOB NUMB R �19�06N�dtd
PLEASE PRINT OR TYPE
Feque� �a�Q 3m � 98 qpa9p-in inspec:lon requlred? 0 Ves ��I[lo Irspection Other Than RooHh-In_ �( Reetly Now 0 Will Call
(YOU must call ihe Inspector when reatlyl Dale Ready: 11 �'30 � 9�$
I, � Ilcensed contractor ❑ owner heraby request inspectlon of the above electrfcal work at:
Job Atltlress (S(reet, Boz. or Foate NoJ City Zip Coce
01358 SKYWdOD LA3 NE FRIDLEY 55421
Section Nn Townshtp Vune or No_ Ra�oe No. Fre No_ Coun�y
ANOKA
Occupanf PM1One No.
JON H LUETH 572-1G82
Elerhicel Gootrector (Compairy Name)
MASTER ELECTRIC Ci
Maling Aodress iCOrrtractor or Ov,�rier Pertormirg
EB-00001A-11 8i95 STATE eOAR� COPY - SEE INSTRU�T16N5 ON BACK OF VELLOW COPV
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