P - 83047REQUEST FOR ELECTRICAL INSPECTION ��
6��_��� � 8121 Universty A earRm. Se128,ISt. Paul, MN 55104
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� Phone (612) 642-0800 ���
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Re air
ir CoT�f Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above the work covered by this request. Enter remarks in ihis space a�o the back of the white copy only.
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Calculate Inspection Fee - This Inspection Request will not be accepfed wiihouf the correct fee:
Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Am s Above 100 Amps
Transformer/Generator INSPECTOR'S USE ONLY TOTAL /�
Sign/Outline Ltg. Xfmr. �
Alarm/Remote Control
Swimming Pool
I hereb certi that I ins ted the eleclrical installafion described herein on the dafes stated
Irrigation Boom Rough-In pa�
Speciallns f
Investi9ative e Finol Dare, 2��o
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THIS INSTALLATION MAY BE ORDERED DIS ECTED IF NOT COMPLETED IN 18 MONTHS.
OFFICE USE ONLY This request void 18 from validafion dafe prinfed in this box.
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LEASE PRINT OR TYPE
Request Da Rough-in inspecfion required$ ❑ Yes o Inspecfion Other Than Rough-In: dy Now ❑ Will Call
���2 ��. (You must call fhe inspector when ready) Dafe Ready:
I, 'censed contractor ❑ owner hereby request inspection oF the above electrical work at:
Job A r�s (S f, B or Route Itl'd!j� �� City ` Zip C
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Secfion No. Township Name or No. Range No. fire No. County �
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�$�96 STA ARD COPY - EE INSTRUCTIONS ON BACK OF YELLOW COPY