P - 82554�"� �� v� 6431 Universiry Avenue Northeast (6127 777-7885 q
FRlDLEY Fridley, Minnesota 55432 FAX,6,2, 5�,-,28� 1 J 14 4
REQUEST FOR ELECTRICAL INSPECTION
"X" Below Work Covered by This Request
Add pep. Type o1 Bullding Appliances W�red
Duplex Water Heater
Apt. Building Dryer
CommerCial Bldg. Fumace
Industrial Bldg. Air Conditioner
F3rm � Other peci v
t r uec�fy ther
�ute lnspectron Fee Below
Fse ServiceEntranceSize p Fae Feeders�Subteeders
OtolUO s Oto30Am s
107 200 Amp 31 to 100 Amps
Above 00 Amps Above 100_Am
Transformers Remote Control Circ
Signs Speciai Inspection
�ks �.'""(aiC`'/a0� G�� Co S�/�tsi�C •-�v��cY4
S
����.�
Equ�pment Wired
Tem�orary Service
Ughting Fixtures
Electnc Heat�n
Silo Unloader
Bulk Milk Tank
Other ISne��irVl
Other
Fee I C�rcuits
0 to 30 Arr
31 ro 100 t
Ahove 100,
Partial �Oth
�s"� TOTAL FEE
r:
Hough-in Dnte �, the Electrleal
Inspector, hereby
certify that the nbove
Final ^ inspechon has been
made.
��5 rCyuCSI vU'�O
18 n�onths from
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This reque5t vo�d • �/'�� �
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18 monihs from '� � 1���� f.
� �U�� ��,�tL�
Re.quest Date fire No. Fough-�n Inspect�un
�� ��� ReQuired? �Ready Nuw �ill Notit� inspec-
❑�es o 1or When Ready
Licensed Electncal ConVactor 1 hersby request inspechon of above
❑ Owner electncal work instalted at