The URL can be used to link to this page

P - 847431 lV VLLI Fridley, Minnesota 55432 FAX (612) 571-1267 � o Q� 0 REQUEST FOR ELECTRICAI INSPECTtON ""X'" Below Work Covered by This Request Add Reo. vDe ol Buildinq Appliancsa Wi�ed Equ�pmsnt Wired Home Range Temporary Service Duplex Water Heater Lightin Fixtures Apt. Building Dryer Electric Heat�n Commercial Bldg. Furnace Silo Unloader Industrial Bidg. Air Conditioner Bulk Milk Tank Fd�m ther peu v ther (Specifyl t r peci y ther Other � ompute lnspect�on Fee Below p Fsa SarvicsEntrsnc�Siae p Fee Feeders�Subfeaders b Fea Circuits 0 to t UO Am 0 to 30 Am s 0 to 30 Am 101 to 200 Amps 31 to 100 Amps 31 to 100 Am Above 200 Amps Above 100_Am s bove 100_Amps Transfor s Remote Control Circ. rtial!Other Fee $igns S ecial Inspection Remarks _ S�� U� TOTAL FEE .I�� / - 1.2 � �. Rouqh-in Date I, th� Elsctrical � � InsDSCtor, her�by F�nal pA�P c�rufy thst tM1� ebovs � , ►, � insp�ction has 6ssn msds. 7his request va�d . . 18 nanths from Th�s re0uest void � / � 1 � O � ^ ^� �� Q ^ ^ O 18 months trom JC/ J u� 1 Re+quest Date F�re No. Rouph-�n Inspec[�on ! , `)� �� Required? �Ready Nuw Q Will Notify Inspec- �� ❑ Ye5 ❑ No tor When Ready Ucensed Eiectncai Contractor 1 h�r�by rsqwst inspechon ol �bovs ��ef slectrical work installsd at: Sveet ddress, Boa or u[e No. Citv ' `� � � � ' � � ��— /—!� l� L � OccupentlPRINTI Pnone No. Powar SuDPl�er . Address Elec al Contractw ICompany Namel � Contractor's License No. ? �fC '. �'' i 2 i �. Ma�lin Address IContracto w Owne� Makinp Ins� ' lonl � ��u� �---� �� L�.� � /s'�,c..-�%i �'� ��/o AuMonzed Sipnatur� IContractor Owner Mak��q Installa �on1 Phone Numbe� ^� +4: , i ! tr � ,