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P - 77993REQUEST FOR ELECTRICAL INSPECTION ""X" Below Work Covered by This Request Add N�D• Type o1 BuUdinq Apo��ancss INirsd Home ��9e Duplex Water Heater Apt. Building Dryer Commercial Bldg. Furnace Industrial Bidg. Air Co�ditioner Farm �n>. _ oeci v t r ueci v �te Inspect�on Fee Below Fee S�rvic�Entr�nt�Sizy 0 to 100 Am s t, 101 to 200 Amps Above 200 Am , Transformers SicT�s � I Fee Feeders�Subfesders � Oto30Ams � 31 to 100 Amps Above 100 _ Am 5 Remote Control Circ. peciallnspection 5 2283 Equ�oment Wired Temporary Service Lighting Fixtures Electric Heat�ng Silo Unloader Bulk Mllk Tank ther ISpec�tvl Other Fee ci.��s Oto30Am 31 to 100 Am �� Above 100_Am ; Partial!Other Fee �� TOTAI FEE v Rouph-in Va1e 1, ths Elactricel Inspector, hersby certity thet tha abovs Final �� ., �'��P insD�ct�on has bsen ��S-O m�de. Thls request vo�d 18 months hom � _ a-r's-s:as�. a.i-� .. � � � � �...� �.. � � � � .. - -------�---�--------- -- �.��9�f� ��0� T�is rbquest vo�d ^ /� +� 18 monthsY.from /, � J +�I �� / �r R 'S �riy��.� �c. r�� v v�a,itJ � Request lE F�re No. Rouph-in Inspect�on Required? �Ready Nuw �'j Will NoUfy Inspec- �/�.. � ❑ Yes ❑ No tor When Readv �� censed Electncal Contrector -eY+► I b�nby ��qwst inspect�on ol sbovs pwner V j r •Isctrical work install�d st� 5��..ei �ddress, Box or oute No. /) � ,�,�I' �� _ /„ � Occupe INTI , O Powsr SupD��er� / /j _ � X �� E�ectncal Co or lC� AAa�l�np Addr s IConira er or s,�rn�.a� Sionatura IComract lakinp Insta�tationl r Mak�np Inscallat�onl Pnone No. Contractor�s Uce�se No. umber