P - 81369i 1 REQUEST FOR ELECTRICAL INSPECTION r��.
'(�II (�III I II II I II I II IIII I IIII III Minnesota State Board of Elechici}y ���.
� 1821 Universiry Ave., Rm. 5-128, St Paul, MN 55104 �
yc ot Phone (612) 642-0800 �"'�`-
03924164 -
Home Duplez Apt. Bldg. Other New Addn
the
Hh
Other:
Service �
is y�ace and on the back of the white copy onty.
SAVER'S SWITCH INSTALLATION
u7ate lrtspection Fee - This Ing�ecGOn R�uest wil! not 6e accepted without the comect fee:
Other Fee � Service Entrance Size Fee � Circuits/Feetlers
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street LtgJ7raffic Sig. Above 200 Amps Above 100 _ Ami
MSPECTOR'S USE ONLY
Xfmr.
Fee
�
.,..����������ar�ey� inereM N oe
ceMi that I Ins p.etl IDe olecidcal insiella[ion descnbetl herein on �ha tlate5s�atetl
Irrigation Boom Rou9n-m oa�e -
C $�acial, 1„n,ene�ifnn 1 SfA
Investigative Fee F��a� ��ti-�---- 1e�s %�
THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHC
____ _.___.
OFFICE USE ONLY This request vold 18 m hs Gom velldatlon tla[a prin[etl in ih's box.
392-41 �]4 � �a� �
JOB NUMBER M9�j06080
PLEASE PRINT OR TYPE
Repue��Qald'3��9fj IRwgM1-irinspeaticn�equiretl?�Ves �o IlrspeclionO�M1¢rTM1anNOUgM1-I¢[
(YOU mi�st c&II the Inspector when reaey� Oate Reatly:
I, � Ilcensed contracNr ❑ owner hereby request inspectlon of [ne above electrical work at'.
Job Address(SVea�,BOx,or Faute NoJ Clty
¢tfa14f4f ^aTINSON BLY FRIDLEY
Sec�ion No. Township Name or No. Rznge Ne Fire No. Gounty
ANOKA
n�.����m Pnone No.
FRANK S WRZIS
Power Suppllsr utltlmss
N5P MPLS OFFICE
ElecVicel Con[rae�or (GOmµ ny Namo) Conhacror License No.
MA5TER ELECTRIC CO.,INC. CA011'32
Maling Atldress (COMractor or Owrier Por(orming Inslallallon�
1'2467 BDONE AVE S.SAVAGE MN. 55378
Reatly Naw 0 Vlill Call
Zip Cotle
55432
574-1480
Mester Lic. No. (Plent Elc
Pno�z no
4712/890_
E9-00001A-11 8%95 STATE B�ARO COPV - SEE INSiF211CT10N5 ON BACK OF YELLOW COPV