P - 83013-( IIII�� IIIII IIIII IIIII IIIII IIIII I�II) IIIII IIII III) M$ n� Uota SsatOe BoaLR o SReC8cStNS PEnCN ION04 ����`.
* 0 3 7 9 8 0 0 6�` Phone (612) 642-0800 �����
Home Duplex Apt. Bldg. Other: �� � C New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. oad Mgmt. Other:
Dryer Range Elec. Heat emp. 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 INSTALLATION
Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee:
Other Fee # Service Entrance Size Fee � Circuits/Feeders
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Amps Above 100 Am
Fee
Transformer/Generator INSPECTOR�s use oN�r TOTAL S'O
Sign/Outline Ltg. Xfmr. 15. ��
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boo Rough-In Date
peciallnspection 15.0
i� Daye �^
Investigative Fee / '-� — !
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.
37s-soo� �a •
j5
,�,.�j3i9 JOB NUIlHER �970600
PLEASE PRINT OR TYPE
Request Da,� � 19 � 9$ Rough-in inspection required? ❑ Yes ❑ NoK Inspection Other Than Rough-In: ❑ f�ady Now ❑ Will Call
(You must call the inspector when ready) Date Ready: �� t q� 9�
I, ❑�censed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
05682 W BAVARIAN PAS FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant
KATHLEEN R
Power Supplier
Electrical Contractor (Company Name)
BENSON
Address
Mailing Address (CoMractor or Owner Performing Installation)
Authorized
(Contractor or Owner Performing Installation)
Phone No.
MPLS OFFICE
Contractor License No.
EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
571-7191
Master Lic. No. (Plant Elect. Only)
Phone