P - 82625c� tY c.�r M� ° �� .
FRIDLEY 6431 UniFndley, M nnesotar55432 FAX (6�12) 571-1287
REQUEST FOR ELECTRICAL INSPECTION
"'X'" Below Work Cavered by This Request
N Add ReD� Type oi Bwlding Appllances Wired
Duplex
Apt. Building
Commercial Blc
Industnal Bldg.
Farm
ite lnspection Fee Below
Fse SsrvicsEntranceSiza
0 to 100 Am s
101 to 200 Amps
bove Z�� Amp<.
r rmers
ema r Ks
ough- i n
F�nal
Water Heater
Dryer
Furnace
Air Conditioner
Other o�v�
Fee Feeders�Subfeeders
Oto30Am s __
31 to 100 Amps
Above 100_Arnp
Remote Control Circ
Special Inspect�on
%7 t�IJ _F.
�i � 15 0
Equ�pment Wired
Temnorary Service
�ighting Fixtures
Electnc Heat�ng
Silo Unloader
Bulk Milk Tank
Othe� ISPe�;��y)
(�iher
p Fee Circuits
0 to 30 Am <
31 to 100 Arr
— Above 100_
Partia l �Other
5�0,�� TOTAL FEE
Date
I, the Electricel
. Inspector, hereby
cert�fV that the ahove
�^�P inspsction has been
.�/'?_ l'9� made.
I Th�s request vo�id ��
1C � ,.�4- {-nm
This reques� void • � a�J �t,.,�� .e ,� s 4� � l
18 months from ���� � t� i�, �J
3
Request Date fire No. pough-in InsDecnon
�/�/� Required� �Readv Nuw Q Will Notify Inspec-
�(/O ❑�es �No tor When Ready
❑ Licensed Electr�cal Contractor I he�eby roquest inspechon of above
❑ �`�'�e� electncal work ins�alled at: