P - 82740RE(�UEST FOR ELECTRICAL INSPECTION �
�� �� 6 71 Minnesota State Board of Electricity
1821 University Ave., Rm. S-128, St. Paul, MN 55104 �.
Phone(612)642-0800
Home Duplex Apt. Bldg. Other: New Addn
ercial Industriol Farm Remod Re air
Air Cond. Hfg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above ihe work covered by this request. Enter remar s m this space and on the back of the white copy only.
Ne�
tie-in �i• freezer
Calculate Inspection Fee - This Inspection Request will not be accepted without the wrrect fee:
Other Fee # Service Entrence Size Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Sheet Ltg./Traffic Sig. Above 200 Am s Above 100 Amps
Tra�sformer/Generator INSPECTOR'S USE ONLY TOTAL
Sign/Oudine Ltg. Xfmr. Z�.rJ�
Alarm/Remote Control
Swimming Pool
I hereb certi tfwt I ins the elechical inslallafion described herein on the dates sfaled
Irrigation Boom go„9�,.�„ pare
Special Inspecfio
Final
Investigative Fee "
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This requesl void 18 months from validafion date printed in this box.
II II • ����
IIIIInI IIIIIIII�III IIIIIIIIIIII��I�I
* 0 5 6 7 6 7 L 3�K PLEASE PRINT OR TYPE
Requesf Dafe Rough-in inspecfion required$ ❑ Yes o Inspectio� Qlher Than RougMn� Ready Now ❑ Will Call
2�18�98 �`(ou musf call the inspector when ready) Date Ready: i� ��
I, �icensed contractor ❑ owner hereby request inspection of the above electrical work at:
bb Address �Slreet, Box, or Roule No.l , Citv 7io C�P
$ecfion No. � Township Name w No.
Gy
Occupant
Wendy's Restaurant
Power Suodier w ..
Mailing Address �Conhacfor or
Aufhorized $ignalure
or
Range No.
ay
Inc
55303
Fridle �'i`J.Z
Fire No. Couny
Anoka
Phone No.
l.� � L���10�
:onhacror License No. Master lic. No. (Planf Elecl. Only)
CA00593
� � � (� Phone No.
421-6846
IONS ON BACK OF YELLOW COPY