P - 80947RE�UEST FOR ELECTRICAL INSPECTION �
7,1 ����� � 8121eUnivessry Ave�,rRm. S 28,ISt. Paul, MN 55104
' Pnone (siz� sa2-oaoo r
Home Duplez Apt. Bldg. Other. New Addn
Commerciol Indusfriol Form Remod Re air
Air Cond. Hlg. Equip. Water Htr. Lood Mgmt Ofher:
Dryer Ronge Elec. Heoi Temp. Service
"X" above the work covered by lhis request Enfer remorks in �his space and on Ibe back of the white copy only.
Wiring A/c
Calculate Inspection Fee - 7his InspecYion Requesi will not be accepted wilhouY the correc� fee:
Other Fee # Service Entrance Size Fee Circuifs/Feed Fee
Mobile Home Pork Stall O to 200 Amps 0 to 100 Amps 2.0
Streel Ltg./Troffi< Sig. Above 200_Amps Above 100_Amps
Tmnsformer/Genemror INSPECTOR'S USE ONLY TOTAL, G
Sign/Oudine Ltg. Xfmr. � i 5..:%O
Alarm/Remote Control
Swimming Pool i he,e6v �en�ti �hm I �o,ce« w ihe elenr��l ��:mllai�o� de.xr�bed here�� on �,e da�e.:�ared
� Investigofive Fee I � � �
THIS INSTAL4ATION. MAY BE OROERED DISC ED IF NOT COMPLETED V
I�� II I� � III II III II III II I� II III II III I I�I OFFICE USE ONLY Thia �e9uast voro' 18 monlhs kwnypl
�
* 0 7 1 7 3 2 8 9*
PLEASE PRINT OR TYPE
Requas� Da�e Raugh�in'mspection required? ❑ Yes No Inspetlion Olher ihon RooyhJn
04-05-99 iro�m����ou�he��„«b,wne�,�aY� Da�eReaa�: 04-05
I, LTlicensed contmcior � owner hereby request inspec�ion of the above electrical work at
lob nddress �Srcee1, Bwc, ar Rwre No.� Gy
160 Pilot Ave. NE. Fridley
Secfion No. Townnhip Name or No. Range Na Fire No. Counry
Lora Pyka
��f.Y�
78
i date prinmd in �h'�s box.
�'�-��
��
Ready Now � Will Call
55421
574-2084
Brandon Electric. Inc. ICA00307 I
��� aad,e.� �com,a��« w ow�e, aa,ro,mmy m:miiaro�i .�r��i/�
7701 Colfax Ave. N. BrobltAqar�a Park, MN 55444
� e(Conhactor w Owner Pehwmi�g Inslallotion� ` Phone No.
1 ����� 560-5311
OOIA-I i 8/96 a
STATE BOAHD COPV - SEE INSn+���nnue o�a BpCK OF VELLOW COPY