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P - 81505FRlDLEY 6431 Unlversiry Avenue Northeast (�rrL7 iii-ron� Fridley, Min�esota 55432 FAX (612) 571-1287 REQUEST FOR ELECTRICAL INSPECTtON '"X" Below Work Covered by This Request Add R�p. Typs ot Buildin9 Appliancea Wirsd Home Range Duplex Water Heater Apt. Bui Iding Dryer Commercial Bldg. Furnace Industrial Bldg. Air Conditioner �..,._ . ther �eci v ite lnspection Fee Below F�e SsrviceEntrsne�Sizs 0 to 1 UO Am s 101 to 200 Amps Above 200 Amo: Nougn-�n - F�nal This reduest void � � 18 months from �_—_T� This request void 18 months trom Request Date 3-��- �9 �Licensed Electncal Contractor ] Owner il Fee Feeders�Subfeeders � 0 to 30 Am s 31 to 100 Amps Above 100—Am s Remote Control Circ. Speclal Inspection S 101C�4 Equ�pment Wired Temporary $ervice Lighting Fixtures Electric Heating Silo Unloader Bulk M�Ik Tank ther (Specity� Olher Fee Circuite 0 to 30 Am � 31 to 100 Arr Above 100_ Partial�Other '� UD TOTAL FEE --�° I, th� Electncal . Inspsctor, h�r�by cs�tilv thet th� ebovs Dnte r i�speetion has been (�. -c —_ � ^ � �� mada. ----- - -__�-__-- 30 l�'-101 �� 04 fne No. Rouqh-in inspection ReQuired7 �Ready Nuw Q W�II NoUfy Inspec- ❑�es �No ior When Ready 1 hersby rsqu�at inspsction ot abovs slsctrical work installed at: