P - 79843�"'j �� v� 6431 University Avenue Northeast rQ4ff 777-7885
FRlDLEY Fridley, Minnesota 55432 FAX (612) 571-1287
REQUEST FOR ELECTRICAL INSPECTION
"X' " Below Work Covered by This Reques�
Add Rep. Type ol Building Appliances Wired
Home Range
Dupiex Water Heater
Apt. Building Dryer
Commercial Bldg. furnace
Industnal Bldg. Air Conditioner
FdffTl - Other peu y
t r peCify
ite lnspectron Fee Below
Fae SarvicaEntrsncsSi:e
0 to 1 UO Am s
101 to 200 Amps
Above 200 Am ,
Tra mers
Sims
r
Fee Feeders�Subfeeders R
Oto30Ams
31 to 7 00 Amps
Above 100_Am s
Remote Contro I C i rc.
Special Inspect�on S
ate
.1";�rl
�;
Equipment Wired
Tem�orary Service
Lighting Fixtures
Electric Heating
Silo Unloader
Bulk Milk Tank
Othe� iSoe�;ifyl
Olhe.
Fea Circuits
� to 30 Am �
31 to 100 Arr
Ahove 100—
AL FEE
I, ths Electricsl
InspeCtor, hersby
cartify thet tM1S above
I F�^a� l�i/ t7 U� I D^�P� �inspectfon has bssn I
� � 'J� maea.
This reQUest vo��d �
18 nanths from �
This «a�e5, �o,d � 1019
18 months trom �
#4ass o,oa
R te frre No. Rough-�n �nsDection
F1eQuired? �Ready Now Q Will Nouty Inspec-
p2 � Yes a tor When Ready
� Ucensed Elec ncal Contractor 1 bersby �equast inspectwn of above
�wner slsctrical work installad at: