P - 82851.t�I��IEI��III�IIIII�IIIIIIII�IIIIIIIIIIIIIIIIIII) R8 (�UE3e SFORve.LRm. SR1 8 SiN SPECNION04 ���,,,��`
Minnesota State Board of Electricity �
�` 0 3 7 9 8 7 2 5* Phone (612) 642-0800 �"�%""
Home Duplex Apt. Bldg. Other: t^ New Addn
Commercial Industrial Farm `-� Q S� Remod Repair
Air Cond. Htg. Equip. Water Htr. oad Mgmt. Other:
Dryer Range Elec. Heat emp. Service
C" above the work covered by this request. Enter remarks in this space and on ihe back of the white copy only.
SAVER'S SWITCH INSTALLATION
ulate Inspection Fee - This Inspection Request will not be accepted without the conect 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 ,sp
Sign/Outline Ltg. Xfmr. 1 `-J. $�'
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
. . inal � �/ D�---�� I Dat�—/ � l �
Investigative � � _�
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
379-872� � �� •
� (�
�� 5,3� J JOB NUMBER �970600�
PLEASE PRINT OR TYPE
Requesi Da� � i 9 � 9$ Rough-in inspection required? � Yes ❑ Nq� Inspec[ion Other 7han Rough-In: ❑ Aeady Now 0 Will Call
A lt
(You must call the inspec[or when ready) Date Ready: 6I S.q ��8
I, ❑}(censed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
05890 STINSON $LV FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant
Phone No.
MARILYN J LARSON 571-0615
Power Supplier Address
NSP KPLS OFFICE
Electrical Contractor (Comparry Name) Contractor License No. Master Lic. No. (Plant Elect. Onty)
MASTER ELECTRIC CO. INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
or Owner Performing.lnstallation) � Phone No.
EB-00001A-11 8/95 STAIE BOARD COPY - SEE INS7fiUCT10NSbN'dA91� 6A' WLLOW COPY