P - 84096! I�III (IIII IIII) IIIII IIIII IIIII II�II IIIII III) IIII 1^82�1 U�iverst0 B e LR � SR �C8 6tNS PEMN IONo4 ����:
� �" 0 3 7� 6 7 0 1 * Phone (612) 642-0800 �_���
Home Duplex Apt. Bidg. 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 ihis 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 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 ONLV TOTAL
Sign/Outline Ltg. Xfmr. 1S. 50
SWIfTII'Tllllg PO � f ���! � I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rou9n-in oace '
Speciallnspection 1 . 50 Finai
Investigative Fee � — Z—
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.
371-670 [� � �
����� � �
JOB HUMBER #9706000
PLEASE PRINT OR TYPE
Requ�T��l'� �+3'� Rough-in inspection required? ❑ Yes �lo Inspection Other Than Rough-In: � Ready Now ❑ Will Call
(YOU must call the inspector when ready) Date Ready: 10I �. % I9%
I, L licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route NoJ Ciry Zip Code
05848 WASHIHGTOH ST NE FRIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
AHOKA
Occupant Phone No.
CLYDE V liORAYETZ 574-9810
Power Supplier Address
Electrical Contractor (Company Name) I Contractor License No. � Master Lic. No. (Plant Elect. Only)
Mailing Address (Contractor or Owner Performing
or
r.,, .
STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF VELLOW COPY
Phone No.