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P - 81645", •• �• 6431 University Avenue Northeast �61'P) 777-7885 . f�.1 {, FRiDLEY Fridley, Minnesota 55432 FAX (612) 571-1287 � 11 !�.i � REQUEST FUR ELECTRICAL INSPECTION "'X" Below Work Covered by Thrs Request Add Rep. Type ot Building Applia�ces Wired Home Range Duplex Water Heater Apt. Building Dryer Commercial Bldg. Furnace Industrial Bldg. Air Conditioner Other oer.i v Farm t r UeGfy ute Inspect�on Fee Below Fss SsrvicsEntranceSize Otol00Am s 101 to 200 Am Above 200 Transformers SiQns l'1 � f�nal k Fae Feeders�Subfeeders Oto30Am s 31 to 100 Amps Above 100-Amp Remote Control Circ Special I�nspection i % 6L.�74l�� Equipment Wirad Temporary Service Lighting Fixtures Electrlc Heat�nq Silo Unloader Bulk Milk Tank �her �Soecityl Other Fee 0 to 3( 31 to 1 Partial'Oth S �_ � TOTAL FEE '- I, the Electrical . Inspector, hersby urtffv thst ths ebovs �P insp�ct�on hsa bes� 9�% m.ea. Th�s request vo�d 18 nantbs from � �-�s-r=s-��-�:� ..��.�-��--- ----�a�4........w�.�.�,c�.+..�, -_ • Th�s requBSl void oo � I' / 2/� 1016 3 18 months from � �� „)�J Request Oate Fi�e No. Rough-�n InSpecti0� ReQuired? �Readv Nuw Q W�11 Nptify Inspec- / �^ � � � � Yes ❑ No tor When Ready Licensed Electr�cal Contr�ctoi 1 h�reby rsquest inspectio� ot sbove ❑ Owner slectrica� work installsd at: