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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. �� ���� ��� ��� � 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. IH�IIIIIIIIIINNiiIi�N�llllllllllll � . ��-� IIIIIIII * 0 6 1 6 2 2 8 3* /loUv� 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. � � � 786-8484 EB40001 1 8/96 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY