P - 82462�"� �� �� 6431 University Avenu� Northeast �i'rtij 777-7885
FRIDLEY Fridley, Minnesota 55432 FAX (612) 571-1287 � �,� i v l
REQUEST FUR ELECTRICAL INSPECTION
""X'" Below Work Covered by This Request
Add Rep. yDe ot Building ADP�iances Wired
Home Range
Duplez Water Heater
Apt. Building Dryer
Commercial 91dg. Furnace
Industrial Bldg. Air Co�ditioner
Fdrm Other DBCi 0
� r uec� v t er
Compute lnspection Fee Below
p Fss ServiceEntrancsSlzs t+ Fee Feeders�Subteeders
0to100Am 0to30Am s
101 Yo 200 Amps 31 to 100 Amps
Above 200 Am s Above 100_Am �
Transformers Remote Control Circ.
. Q pdqs,,� Special Inspection
Equ�pment Wired
Temporary Service
Lighting Fixtures
Electnc Heahnq
Si lo Unloader
Bulk Milk Tank
ther (Soec�ty�
Other
fea Circuii
0 to 30 Am
31 to 100 A
rartia i � vtn
S /g � TOTAL FEE
�n�s repue5t vtr�0
This request void
18 months from
:quest Date
/O � 1 lo -oo
Licensed Electr�cal Contractor
Owner
,e��a 3
l 9�00
F��e No.
10157
iph-in InsDecl�on
uired? �Ready Nuw Q Wil1 Noufy I�saec-
� Yes ❑ No tor When Ready
I h�r�by rsqusst inspection ot sbove
alectricai work installed at: