P - 80504Ct�O� Municipa! Center (0-5 �
FRiDLEY 6431 Un�Feidley, M nnesotar55432 FAX (61� 571-1287
REQUEST FaR ELECTRtCAL INSPECTlON
'"X'" Below Work Covered by This Request
Add Rsp• Type ol Buildi�g ApD�iances Wirad
Home Range
Duplex Water Heater
Apt. Bui Iding Oryer
Commercial B�dg. Furnace
Industrial Bldg. A�r Conditioner
F Other pec� v
arm
t er uecify
ite lnspection Fee Below
Fsa SsrvicaEntrsneeSi:e
0 to 1 UO Am s
101 to 200 Amos
Rougn-i�
Final
This request void
18 months from
Request D Fire
- o7C �p /
Licensed Electncal Cont��ctor
� Owne�
Fee , Feeders�Subteeders t
0 to 30 Am s
31 to 100 Amps
Above 100_ Am s
Remote Control Circ.
Speciallnspection S
�� �..r � �; �
Equ�Dment Wired
Temporary Service
Lighting Fixtures
Eiectnc Heatmg
Silo Unloader
Bulk Milk Tank
ther iSoec�tv)
Other
Fee Circuits
0 to 30 Am
31 to 100 Am .
—�l Above 100_�
Partial!Other F
/) TOTAL FEE
Uate �. ths Eleetrieal
. lnsAector, hersby
csrtlty thst tha abovs
Dnte ��spsehon has been
��, msds.
°�'O 4.� v
,��+��� 1018 3
Fough-in InsDect�on
Required? [�Ready Now � W�11 NoUfy Ingpec-
� Ves � hlu �or When ReadY
I b�rsby roqusst inspection ol Abov
elsctrics� work ins�alled at: .