P - 83214REQUEST FOR ELECTRICAL INSPECTION
�'� °`° ���" � 8121 Uni essity A earRm. Sei28,ISt. Paul, MN 55104
Phone (612) 642-0800 '�� �
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial farm Remod Re air
Air C Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above the work covered by fhis request. En►er remarks in ihis space and on ihe back of the whiie copy only.
Calculate Inspection Fee - This Inspection Request will no; be accepted without the correcf 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. 15. 50
Alarm/Remote Control
Swimming Pool
I hereb ceni thot I ins the elechical installafion described herein on the dates stated
lrrigation Boom RougMn pa�
Special Inspectio
f�� °°�a_ z�=
Investigative Fee d
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
. OFFICE USE ONLY This request void 18 monffis from validation date printed in this box.
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* 0 6 4 1 2 4 8 0* yl0 7
. PLEASE PRINT OR TYPE
RequesT Dafe R h-in ins ction r uired$ ❑ Yes
6-25-98 � � � �No Inspection O�er Thon RougMn: (]�Ready Now � Will Call
�You must call the inspector when ready� Date Ready:
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Sheef, Box, or Route No.� City Zip Code
126 Ventura Ave Fridley 55421
Secfion No. Township Name or No. Range No. Fire No. Counly �
Occupont Phone No.
Rose Martin 572-1005
Power $uoolier Address
Total Electric Inc.
Mailing Address �Confractor or Owner Performing Insfallation)
1537 9 nd Ln NE Blaine MN 55
Authorized Si afure �Conhactor or Owner Py�f6lij ning�lnstallafi
�
i
ConfracYOr License No.
CA02749
- �
BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
lic.
No.
786-8484