P - 81052�"' '' �� 6431 Universit Avenue No!theast (�r7�E'� 777-7885
FRIDLEY Fridley, Minnesota 55432 FAX (612) 571-1287
RE�UEST FOR ELECTRICAL INSPECTION
"'X'" Below Work Covered by This Request
Add Rep Type of Building Appliances Wired �
Home Range
Duplex Water Heater
Apt. Buildfng Dryer
Commercial Bldg. Fumace
Industrial Bldg. Air Conditioner
�...... Other peu v
'ompute lnspect�on Fee Below
p Fse SsrviceEntrsneaSizs
0 to 1 UO Am s
101 to 200 Amps
Above 200 Am :
Transformers
Si
Remarks �, n A_�!;
�� �//�
Rough-in
Final � �.�.1
Fee Feeders/Subfeede�s
Oto30Am s
31 to 100 Amps
Above 100�Am �
Remote Control Circ.
Speciallnspection
�?_e'79-�0
;�
U i L
Equ�pment Wirad
Temporary Service
Lighting Fixtures
Electr�c Heat�nq
SUo Unloader
8ulk Miik Tank
the� lSoecity)
01her
fee Circuits
� to 30 Am �
31 to 100 Arc
S�D (�(� TOTAL FEE
Dace 1. th� Electrical
� ��sDector, hersby
csrtify thst the nbove
�^�P i�spaction hqs bsen
+� .. - meds.
Th�s reduest vo•�d "" �
18 nionths from. � jy � �� ^ "
l ��
Th�s request void /D��� 10123
18 months from � � ��
Request Da f�re No. Rouph•�n Inspec[ion
'� �Q Neduired? �Ready Nuw Q W�1I Nouiy insPec-
/ '" � ❑ Ves � No tor When t9eadv
Licensed Electr�cal Contractor 1 hersby requsst inspaction ot above
Owner alectrical work ioatalled at � �. .