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P - 84705flllULt.Y � F��die'y, Minnesota 55432 FAX (612) 571-1287 ,� ��,� 8 REQUEST FOR ELECTRICAL INSPECTION '"X'" Below Work Covered by This Request Add Rep• pa o1 Bu�ldinq Applia�css Wired Equlpment Wired , Home Range Temporary Service Ouplex Water Fieater Lightin Fixtures Apt. Building Dryer Electric Heatin Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk M�Ik Tank F3rm � Other pec� v ther (Soecityl t r peCl Y ther 01her Compute lnspection Fee Below J1 Fse Servic�Entrsnc�Si:s M Fes Feeders�Subfeeders p Fea Circuita �tolUOAm Oto30Ams Oto30Am 101 to 200 Amps 31 to 100 Amps 31 to 100 Am Above 200 Am Above 100_Am s bove 100_Amps Transformers Remote Control Circ. � Partial�Other Fee Signs Special Inspection S �. � TOTAL FEE Remarks � I���I +" ...,1 1 J�J�1 Rouph-in Date I, th� Electrical . Inspector, hersby cartily that ths ebove final �^�P � inspection hss bsan �f% —1 m�de. This reQUes vo�d 18 montMs f °' (� �ti��� �_�_ ��__ ;� -----� 1��18 ��s� �3 � Fi�e No. qequhed�lnspecc�on �peadv Now QW�II NoUfv Inspec- / _ E tor When Ready //„ ❑Ves ❑No Yr d Electncal Contraclo� I h�rsby �equest insPecnon ol sbove slsctrical work installed at: i Address, Box or Rout . C��y -., S � /�,��Q Occu IPRINT) � � Pno��e No. r l� i �S � Power SuDV�� . Addr s ' �� � � ��� � . � . J- � Elecuical ntractor ICompanv Namel Contractor's License No. i/ S (� �� �` �� Mailinp Addr�tractor or Owner Meklnp Instailatwn) ` � Phone Number AuMorized Sip�stun (CoMractor Owner MakinQ Instaliation)