P - 80942",^�° � � RE�UEST FOR ELECTRICAL INSPECTION `��"=.',,
�1�� - 211 � 8'21 Univessty A e�,rRm. Se128, SL Paul, MN 55704 �*�
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Phone (612) 642-0800 ����� �
me Duplez Apf. Bldg. Ofher: New Addn
Commercial ��, Industriol Farm Remod e air
-� Air Con . Hfg. Equip. Water Htr. Load Mgmt Oiher:
Dryer Range Elec. Heaf Temp. Service
"X" above the work covered by �his requesG En�er remorks in tfiis space ond on �he bock of ifie white copy only.
Suburba+rt� 220�1�, fif c
Calculate Inspecfion Fee - This Inspection Requesl will nof be accep�ed wifhout Ihe torrecf %e:
O[her Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Mobile Home Park Sloll 0 to 200 Amps ;Z 0 to 100 Amps 8°�7
Sfreet Ltg./Tmific Sig. Above 200—Amps Above 100_Amps
imnsformer/Generotor INSPECTOWS USE ONLV TOTAL�
Alorm/Remote Confrol �Q �
Swimming Poo� I hereb cern ihm I ire ened fhe eleadml inslallation desci�bed herel� on the dmes smied
Irrigation Boom po„9h�i� � oaie
Special Insp n- F��al , o0
�, 2 6 � �--et
Investigalive Fee �
THI&„{�JSTALLATION MAY BE ORDERED DISCONNECTED IP NOT.COMPLETED WITHIN 18 MONTHS.
/ OFFICE USE ONLV This requey void 78 momhs fmm valida�ion dale prinled in �hls box.
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PLEASE PRINT OR TVPE
Reqoesl Dare RaugMn Inspec�lon required? ❑ Yex �No Inspeclion O�hx Than Rough�ln: i�Ready Now 0 WIII Coll
7 29 �q q �You musr mll ihe inspecror when ready� Da�e Reody
I, �licensed conlractor ❑ owner hereby request inspection of Ihe above elecfrical work at �
bb Address �Slree�, Box, or Roure No.) Ciry Zlp Code
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E800001A-11 8/96 yTATE @QAHD COPY - SEE INSi�PI