P - 77986RE�UEST FOR ELECTRICAL INSPECTION
"X'" Below Work Covered by This Request
Add MD• Type ot Bwldinq ApD��antss Yllirsd
Home Range
Duplex Water Heater
Apt. Bu�lding Dryer
Commercial Bldg. Furnace
I�dustrial Bldg. Air Conditioner
F ther pec� v
Fea
in
1 Flnal
arm
t r Uecify
�ection Fee Be/o
S�rvie� Entrane� Si:
0 to 100 Amps
101 to 200 Amps
Above 200 Am�
Transforme�., ____
Signs �
Feeders�Sublesders A
Oto30Ams
31 to 100 Amps
Above 100 _ Am s
Remote Co�trol Circ.
peciallnspectlon S
��77
Equipment Wired
Temporary $ervice
Lighting Fiztures
Electric Heatinp
Silo Unloader
Bulk Milk Tank
ther lSoec�t�l
Other
fes Circuits
0 to 30 Am
31 to 100 Am s
Above 100_Amp<,
Partial!Other Fee
J� — TOTAL FEE
,te 1, ths Electricel
�nsDSCtor, heisby
certily thet the abovs
'��P ./ insD�ction has bsen
��{ "C" i`' msds.
Th�s reQuest w�d
18 nqnths f�om �
--------���.—�.—��� .r.rsr,.�...r..�a.�-i�.�s���.. ��� ^ ��:��c �a�.sss�.����
A lv` �L�/
Th�s r�Quest w�d
,8 ,��«�..,.�,
�V �� w �/�
i h�r�by r�quast inspsction ot abovs
•ISCtricsl work inatalled at:
�' '�
2�/ /