P - 82060�..a a� va 6431 University Avenue Northeast F6i2� 777-7885
FRlDLEY Fridley, Minnesota 55432 FAX (612) 571-1287
RE�UEST FOR ELECTRICAL INSPECTION
"'X" Below Work Covered by This Request
Add paO• Type ot Building Appliances Wired
Home Range
Duplex Water Heater
Apt. Building Dryer
Commercial Bldg. Furnace
Industrial Bidg. Air Conditioner
Fd�m O�he� pec� v
t r uec�(V 1 er
ompute lnspection Fee Below
W Fse . Ss�vicsEntrsnceSize p Fee Feeders�Subfeeders p
�n
Final
Oto30Am s
�ps 31 to l OQ Amps
Am s Above 100_Am s
Remote Control CirC.
Special Inspect�on �
'C r � , �ll�� f.
� .� -r �
Equipment Wired
Temporary Service
Lighting Fixtures
Electnc Heatmq
Silo Unloader
Bulk Milk Tank
ther ISoecify)
O�her
Fee Circuits
0 to 30 Am
31 to 100 Am s
Above 100_Amp;
Partial!Qther Eee
%Q- TOTAL FEE
1, ths Elettricsl
. I�avecto�, hereby
csrtl}y thst ths ebove
inspsction hsa been
�•�l meds.
This repuest vo�id �
��d'L��z �-s ��.�::sa-r.�x�vs�.��.r�r.:�;�..rr..
Th�s re0uest vo�d • O •�� 0141
18 months from
Requegt De Ftre No. Rouqh•�n InSpection
�� �Q R9❑quired? O �Readv Nuw Q W�II Nc�lify InsPec-
�es No �or When Ready
licensed Electncal ConVactor 1 heroby request �nspecc�on of ebove
Ownei slsctrical work inatalled at: