P - 81528.
�-37-925
Home Duplex
Commercial Indushial
Air Cond. Htg. E uip.
Dryer Range
"X" above the work covered by th
Upgrade to 200 Amp
RE(�UEST FOR ELECTRICAL INSPECTION
Minnesota State Board of Electricity
1821 University Ave., Rm. S-128, St. Paul, MN 55104
Phone (612) 642-0800
Farm
Water Hfr. Load Mgmt. Other:
Elec. Heat Temp. Service
request. Enter remarks in this space and on the back of
New
Remod
copy
Calculate Inspec►ion Fee - This Inspection Request will not be accepted without the correct fee:
Other Fee # Se ' nce Si Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 0 200 ps 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. �.5. 5�
Alarm/Remote Confrol
Swimming Pool
I hereb certi ihat I ins ted the elecfrical installafion described herein on fhe dafes sfated
Irrigation Boom Rougi�ln Date
MAY BE ORDERED 1
�..
1 IF NOT COMPLETED WIT IN 18 MONTH .
OPflCE USE ONLY This request void 18 months from validatior date printed in fhis box.
I� II III II III II III II II I�I III ��
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* 0 7 3? 9 2 5 8 * ��Q�
PLEASE PRINT OR TYPE
Reques� Dafe Rougffin inspection required? ❑ Yes � No Inspection Ofher Than Rough-In: � Ready Now ❑ Will Call
3/ 31 / 9 9 (You must call the inspector when ready� Date Ready:
I, Q licensed conhactor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Sheet, Box, or RoWe No.� Ciry Zip Code
6134 Woody Lane Fridley 55432
Section No. Township Name or No. Range No. Fire No. Counry
o«�paor
Franlc Demello
Phone No.
S� ` _ � •
Elechical Conhactor (Company Name) Conhactor License No.
Total Electric Inc. CA02749
Mailing Address (Conhactor or Owner Performing Installation)
10760 ankato St N Suite 1 Blaine MN 55449
Authoriz prtature IConhoc/or.erOw �l �+ .
Anoka
571-6245
_�„_
Only)
No.
786-8484