P - 81378IIIIIIIII II IIIIII ll Ill REQUEST FOR ELECTRICAL INSPECTION ��
M82�eUnivessry A earR�of SI128ciS1. Paul, MN 55104 ���-
� " 0 3 9 2 3 8 2 8* Pnone �si2� saz-oaoo '^��?�•'`
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Hir. X Load Mgmt. Other:
Dryer Range Elec. Heat emp. Service
"X" above the work coveretl by this request Enfer remarks in this space and on the back o/ the white copy only.
SAVER'S SWITCH INSTALLATION
Calculafe ln.;vection Fee - This /nspecGOn Request will not be accepted without ihe cwreci fee:
O[her 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 TOTA
Sign/Outline Ltg. Xfmr. �� 50
Alarm/Remote Conhol
Swimm'ing Poo I M1ereby certify ihal I inspecled tno elec[rical Insfalletion describetl hereln on ihe tleres sta[etl
Irrigation Boom aa,gn-in o�ce
X Speci211nspection 1 . 5@
Fo-ai oa�
Investigative Fee � _ �o. _
THIS INSTALLATION MAY BE ORDERE� DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLV This request mitl 18 morrths from valitlation dale prinled In ihis box.
392-38?� � is 3-p
/a 6
JOB NUMBER #5�0E000
PLEASE PRINT OR TYPE
Requeft4a[�30��� Rough-In.nsOFCbonrepulretl7DYes �o InsOaIXionO[hzrTFanRagh-Ir_[�qeatlyNOw�WtllGell
(Vou must oali tne Inspaclor when reatly'� pate Ready: �
I. � Ilcensed contractor ❑ owner hereby request inspectlon of Ihe above electrical work at
Job Address (Slreet, eox, or Roeta No.) Clry Zip Coce
@15@8 WINDEMERE DR NE FRIDLEY 5542E
Sedion Na_ TawnsM1ip Name or Na. Renge No. FNe Na Cwnty
ANOKA
Occupant Phone No.
THt7MA5 M MI110GUE 571-6740
Powcr Supplier Adtlress
N�P MPLS OFFICE
Eleotncal Conhactor �COmparry Narne� CenVactor Licerse No. Master Lc. No. (Plant Eleot Only�
MASTER ELECTRIC C0. , INC. CA011'3'2
Maillrg Adtlress (COnhactor or Owner Performing Ins�allatlon)
12467 BOONE AVE S.SAVAGE MN. 55378
AWhorized SignaNre �COrt [or or Owner Periormlrg Installahom � PFrone No.
�2�J�i:�r,
��-3 941 471f�f85
i -__ _
I EB-00001A-11 8/95 STATE BOARD COPY - SEE INSTROCTIONS ON BACK OF YELLOW COPV