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P - 83332._— --- ........� .. oo.,�o .,u+�c rr�n �o ic� ai i-iroi REQUEST FOR ELECTRICAL INSPECTION "'X'" Below Work Covered by This Request Add Rep. yve ot Builtlinq Appliancea Wirsd Home Range Duplex Water Heater Apt. Building Dryer Commerciai Bldg. Furnace Industrial Bldg. Air Conditioner Farm ther oec� v t r peci y 'ompute lnspection Fee Below � Fsa SsrviceEntrenc�Si:s 0 to 1 UO Am 101 to 200 Amps Above 200 Am Transformers Signs 3emarks ,.� i�%� 4o uph- i rt � 6itS'T" � - Th�s r �st vo�d 18 no�i � +� � �� J This request vo�d � 18 months trom /0% licensed E�ectrica� Contractor Owner fee Feeders�Subfeeders Oto30Am s 31 to 100 Amps Above 100_Am re �J Equlpment Wired Temporary $ervice Lighting Fixtures Electric Heatinq Silo Untoader Bulk Milk Tank iher ISoecifvl Circuii 0 to 30 Am[ 31 to 100 A cial Inspection 5��� TOTAL FEE ., � r --�- I, th� Electriul Insoeetor, h�r�by �tify thst th� abov� D'A�P. ��sDection has been C)•�� mede. � �•�� � 10089 r� ipn-�n inspecnon �u�red? �Ready Nuw QW�II NaUfv tnsPec- � Yes � No . tor When ReBdY I b�nby nqwst inapscdoo of �bow- sl�ctrical work install�d �t: