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FRiDLEY 6431 UniFedley, M nnesotar55432 FAX (6� 571-1287
RE�UEST FOR ELECTRICAL INSPECTION
""X'" Below Work Covered by This Request
Add peD� Type ol BuildinB AoP��ancea Wired
Home Range
Duplex Water Heater
Apt. Building Dryer
Commercial Bldg. Furnace
Industrial Bidg. Air Conditioner
F Other oec� v
arm
t r peclfv
�ute lnspectron fee Below
Fse SsrvicsEntrancsSize k
0 t0 1 U '
101 to mps
Above 200 Am
Transformers
Signs
�k5 T
!
7-in
Final
� U l i' G
Equ�pment Wired
Tem�orary Service
lighhng Fixtures
Electr�c Heat�nq
Sito Unloader
Bulk Milk Tank
ther (SPecify)
Other
Fee feeders�Subfeeders b Fee Circui
0 to 30 Am s � to 30 Am
31 to 100 Amps 31 to 100 <
Above 100�Am s Abov 100.
Remote Control Circ. Partial!Oth
Special Inspect�on �O/�
TOTAL FEE
`�'Lc
Date
1, ths Elsctncsl
. InaOSCtor, heroby
csrt�ly ihet tbs nbow
�^�P inspsct�on has baan
� SC al �ds.
Th�s reduest vo•�d �— � '
����: .. I
T�is reQuest vo�d ���"� �/�_ A_•�_L �/ _ �f� I O� I�
18 montbs trom /O� pO C, lZ1��T dOI
eq te F�re No. Rouqh-�n Inspect�on
Requ��ed? �Ready Now Q W�il Notiiy f�sDec-
� � ���� �ves �No [or When Ready
"_'�`
Llcensed Elecv�cal Contr�ctor I hersby requsst inspection of ebov�s
Owner slectrical work inatalled at: