P - 83087REaUEST FOR ELECTRICAL INSPECTION
"'X'" Below Wo�k Covered by This Requesr
Add Rep. Type of Buildin9 ApD��ances Wired
Home Range
Duplez Water Heater
Apt. Building Dryer
Commercial Bldg. Furnace
tndustr;a4 Bldg. Air CorKiitioner
ther oeci v
farm
t r GeCi V
ite lnspection Fee Below
fse SarvicsEntrane�Sizs
0 to 1 W Amps
101 to 200 qmps
� _'� ,�u gns
aemarks
Roupfi-in
Final
This reCuest void
1 S nanths from
M Fes Feeders�Subteeders A
Oto30Ams
31 to 100 Amps
Above 100_Am s
Remote Control Circ.
Special Inspection S
/ '217� <<, �_•
� �: � �
Equ�pme�t Wired
Temporary Service
lighting Fixtures
Electric Heatinq
Si lo Unloader
Bulk Milk Tank
iher ISpecify�
Fee Circuita
0 to 30 Am
31 to 100 Am s
Above 100_Am :
� Partial�Other Fee
1 U�'� TOTAL FEE
I, ths Elsetrical
Inspsctor, bsr�by
c�rtity th�t th� nbov�
� -� spsction hss bssn
mad�.
� L �Y yi� � Y ���-�`Y41R1�1 �iOCil��1�PL�li� �-�- _ �
Th�s reduest vO�d • �• � � 0 O / 8
18 montl�s from � `� /� /� .
! •(J v
Rxquest Oat Fhe No. Rouph-in Inspecuon
�' ) �� ReOquired? ❑ �Readv Nuw Q W�II Not�fy tnspec-
�"I Ves No lor When R9adY
Licensed Electncal Cont�actor i h�r�b� roqwat i�sp�ction o� abov�
Ow�er el�ctricsl work install�d at: