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P - 78625
FIZIDLE.Y V'V V Fridley, Minnesota 55432 FAX (6�12j 571•1287 RE�UEST FOR ELECTRICAL INSPECTION "X'" Below Work Covered by This Request Add Rep. Type of Bwlding Appliances Wired Home Ranye Duplex Water Heater Apt. Bui Iding Dryer Commercial Bldg. Furnace Industrial Bldg. Air Conditioner Farm Other pec� v .ompute inspection Fee Below ++ Fse Sarvics Entrs e i:s Oto1U0A 101 to 200 Amps Above 200 Amps Transf rmers Sign Rema r ks ,,,,� � Rough-in Final Fee Feeders/Subleeders � Oto30Am s 31 to 100 Amps Above 100 _ Am s Remote Control Circ. Special Inspect�o� S �i �1 ��% 0'� Equipment Wired Temporary Service Lighting Fixtures Electnc Heat�nq Silo Unloader Bulk Milk Tank ther ISoec�fyl Other Fea Circu 0 to 30 Arr 31 to 100 � Above 100. --�" Partial!Oth /]�� TOTAL FEE 1, the Electricsl ��aosctor, hersby certlty thet ths ebovs '��P inspac6on has besn 27�3 mede. inis reduest vo�d 18 nanths trom ..e.�..�� - ,�_».__—_------- -�-� -°�^-�.,.�.-°--_-- This request vo�d 18 months from /- a�-o3 Licensed ElecVical Contractor Owner ��3�3 10 2 d�,00 re No. Rouph-in InsPecuon Reawred7 �Ready Now Q Will NoUfy tnspec- ❑Yes �No �or When Ready 1 hersby �equeat inspecbon ot pbove electrical work inatalled at: