P - 82626`� �� "� 6431 University Avenue Northeast F6�2j 777-7885
FRIDLEY Fridley, Minnesota 55432 FAX (612) 571-1287
REQUEST FOR ELECTRICAL INSPECTION
""X'" Below Work Covered by This Request
Add Rep. Type ol Building Appliances Wired
Home Range
Duplex Water Heater
Apt. Building Dryer
a Fse
Remarks
Rou�
f�nal
l:ommerclal Bldg.
Industrial Bldg.
Farm
t r ueu fy
�ection Fee Below
Service Entrencs Si:e
0 ta 100 Amps
101 to 200 Amps
Above 200 Amp�
Transformers
Signs /j
r
rumace
Air Conditioner
Other pec� v
Fee Feeders�Subfeeders
Oto30Am s
31 to 100 Amps
Above 1 00 _ Amp
Remote Control Circ
Specia l Inspect�on
10151
Equipment Wired
Tem��rary Service
Lighting Fixtures
Electnc Heat�nq
Silo Unloader
Bulk Milk Tank
Olher l5pecify)
Other
b Fea Ci�cuits
� to 30 Am s
31 to 100 Am s
Above 100_Amp;
art�al�Other Fee
S� TO7AL FEE
Date
I, the Electncal
Inspector, he�eby
certify that the nbove
Onte inspsction has baen
� /3- de.
This reduest vo�id `� �- -
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Th�s request vo�d �`° •���� `a '
18 months trom • ���� . � '�j 151
Request te� �� Fire No, Rough•�n Insoection
��O � Required� �Ready Nuw Q Wiu No��fy Inspec-
❑ Yes � No tor When Ready
� Licensed Electr�cal Contractor � hsraby request mspect�on of above
� �°"�ef electrical work installed at