P - 83714� I REQUEST FOR ELECTRICAL INSPECTION �'�°'E�
' I,I��II�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 1^g2leUniveSsty A earRmf SI 128cSt. Paul, MN 55104 ��.�_ ��
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* 0 3 6 3 9 3 0 9'�` 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 ot the white copy only.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This Inspeciion 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 s G
Sign/Outline Ltg. Xfmr. 15.-��"
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
j( Special Inspection 1. 00 Final �� �g —�'�
Investigative '
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.
363-930 �f i
/�,�b '� �38a
JOB NUMBER �9706000
PLEASE PRINT OR TYPE
Request�a�e 1^� �{3'� Rough-in inspection required? ❑ Yes �lo Inspection Other Than Rough-In: [X Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready ^� � 1'� � 9']
I, ►J+ licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
06190 STARLITE BLV HE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County �
ANOKA
Occupant Phone No.
CONSTANCE J RIVARD
Power Supplier Address
NSP MPLS OFFICE
Electrical Contractor (Company Name) Contractor License No.
NASTER ELELTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
or Owner
586-0588
1A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
Master Lic. No. (Plant Elect. Only)
Phone No.