P - 82752l 1Vl.JLL1 Fridley, Minnesota 55432 FAX (612) 571-1287
REQUEST FOR ELECTRICAL INSPECTION
""X'" Below Work Covered by This Request
Add Rep. T�pe ot Buildinq Appliances Wired
Home Range
Duplex Water Heater
Apt. Building Dryer
Commercial Bldg. Furnace
Industrial Bldg. Air Conditioner
F ther pec� V
arm
� � UeCi y
ite lnspection Fee Below
Fse SsrvicsEntrenesSizs
Otol00Am s
101 to 200 Amps
Above 200 Am�
�gns
Rough-In '
- a..,,:�r.r ��ar��--
FIna1-.": :<_ � �
Th�s reduest vo�d
18 n�onth5:�
�����r� ----���
Th�s request void • ,
18 mpnlhs from �
Fee Feeders/Subfeede�s �
0 to 30 Am s
31 to 100 Amps
Above 100_Am s
Remote Control Circ.
Speciallnspection S
� �"���
� ��
Equipment Wired
Temporary Service
Lighting Fixtures
Electric Heatinq
Silo Unloader
Bulk Milk Tank
ther (Soec�fy)
Other
te
Dnte
Fee Circuita
0 to 30 Am �
31 to 100 Arr
ove 100_
artiai�Other
TOTAL FEE
I, th� Elsctrical
Inapector, hersby
certify that tha ebovs
inapsction hss bsen
msds.
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q��O�
10055
qequest D e Flre No. Rouph-in Inspection
�_ /'/)�n Reoqu��ed? ❑ �Ready Now Q WUI NoUfy InsDec-
(o �C? Yes No tor WY�en ReadY
�censed Electr�cal Contractor t hersby r�quest inspectlon of above
❑ Owner alsctrical work inatalled at:
�949