P - 83720� l��II�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII M8 C�UoiverstyO BeLR� SR1C8, St PaPEMNION04 �����
* 0 3 6 3 9 4 3 2* Phone (612) 642-0800 '������
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. 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.
SAVER'S SWITCH INSTALLATIOH
Calculate Inspection Fee - This Inspection Request will not be accepied 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 y SQ
Sign/Outline Ltg. Xfmr. lr'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
j( Special inspection . 00
Final � D te
Investigative F � /(�
THIS INSTALLATION MAY BE ORDERED DI NECTED IF NOT COMPLETED WITHIN 18 MONT S.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-943 � �� �� +
�
�5�5� JOH NU?lHER �9706000
PLEASE PRINT OR TYPE
RequesPl�alE 1'� � Gj^', Rough-in inspection required? ❑ Yes �Jo Inspection Other Than Rough-In: � Ready Now ❑ Will Call
(YOU must call the inspector when ready) Date Ready: 7� 1^f' � 9"J
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
06299 TRINITY DR NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
Occupant
WALTER F
Power Supplier
SHUPIEN
Address
Electrical Contractor (Company Name)
or
ANOKA
Phone No.
571-7998
Contractor License No. � Master Lic. No. (Plant Elect. Only)
1A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY