P - 82374�"� �� v� 6431 University Avenue Northeast (�6�-Pj� 777-7885
FRIDLEY Fridley, Minnesota 55432 FAX (612) 571-1287
REQUEST FOR ELECTRICAL INSPEC710N
""X'" Below Work Covered by This Request
Add ReD• Type of Building Appliances Wired
Home Range
Duplex Water Heater
Apt. Building Dryer
Commerciai Bidg. Furnace
Industrial Bldg. Air Conditioner
Fdrm � Othe� peu v
< < ueci v ther
ema
�te lnspection fee Below
Fss SarvicsEntrencsSizs
0 to 100 Am s
� � 1 '�,)to 200 Amps
/
Fee Feede�s�Subfeeders R
Oto30Am s
31 to 100 Amps
Above 100_Am s
Remote Control Circ.
Spec�allnspection S
)21`79� � �
I '0,�' ! v '-�
Equipment Wired
Tem�orary Service
Lighting Fixtures
Electric Heating
Silo Unloader
Bulk Milk Tank
ther iSoecity�
Fee Circ
0 to30A
�1• to 100
TOTAL FEE
noupn-�n � Vate �, ths Elsetrieal
. Inspsctor, he�sby
cartlty thst the ebovs
Final . - �P insDSCtion Aas bsan
'-� meda.
This reQuest vo��d '
--____,:_-_�� � ___;�w�� �
Th�s request vo�d � "�
18 months from `_ __. " �� 1 O I 5 4
qRqu t ate F�re No. RoupN-in InSDecUOn
Nequired? �Ready Nuw Q Will NoUfy Inspec-
❑ Yes ❑ No tor When tieadv
Lice�sed EI tncal Contr�ctor I h�raby rsqwst �nspect�on ot sbove
Owner elsctricsl work inatalled at: