P - 83124, REGIUEST FOR ELECTRICAL INSPECTION
616 � 2 2 8� 1n821eUniversty A earRm. Se128,ISt. Paul, MN 55104
, Phone(612) 642-0800
g Home Duplex Apt. Bldg. Other: g New Addn
Commercial Industrial Farm Remod Re air
X Air Con Htg. Equip. Water Htr. 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.
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Calculaie Inspection Fee - This Inspection Request will not be accepted withouf the correci 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 Am s Above 100 Amps
Transformer/Generator INSPECTOR'S USE ONLY TOTAL
Sign/Outline Ltg. Xfmr. 1.5 ..50
Alarm/Remote Control
Swimming Pool
I hereb certi ihot I ins the eleclrical inslallation described herein on the ejptes staied
Irrigation Boom _ RoogMn Dare
Special Insp � ��
� `Final
Investigative Fee
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
�� OFFICE USE ONLV This request void 18 months from validation date prinfed ir this box.
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PLEASE PRINlT OR TYPE
Request Date Rou fFin ins cfion r uved? ❑ Yes
4-2-98 9 � � � No Inspection Ofher Than RougMn: � Ready Now � Will Call
�You must call }he inspector when ready) Dafe Reody: .
I, � licensed contractor ❑ owner hereby request inspection of the above elechical work at:
Job Address (Sheet, Box, or Roufe No.) City Zip Code
6240 Starlite Blvd Fridley 55432
Secfion No. Township Name or No. Range No. Fire No. Counly
Anoka
Occupant Phone No.
Mary Sjostrom 571-2044
Power Supplier Address
Elechical Confracfor (Company Name) Conhacfor License No. Masfer Lic. No. �Plant Elect. Only)
Total Electric Inc. CA02749
Mailing Address �Conhactor or Owner Performing Insfallafion) �
1537 9 d Ln NE Blaine MN 55449
Authorized Si fure (Conhacfor or Owner Perfor Insfalla' � Phone No. �
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� 786-8484
EB40001 1 8/96 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY