P - 78654"'X'" Below Work Covered by Thrs Request
Add NeD• Typa ot Bu�ldiny APV��ancss Wirad
Home Range
Duplex Water Heater
A pt. Bu�lding Dryer
Commercial Bldg. Furnace
Industrial Bldg. Air Conditioner
F 1hPf OPfI V
arm
t r Uec� y
ite lnspection Fee Below
Fse S�rvic�Ent�snc�Si:e
0 to 100 Amps
101 to 200 Amos
ema
��
F�nal
7Ais reQuest w�d �
18 nanths f�om
Feede�a�Subfeeders 7
Oto30Am s
31 to 100 Amps
Above 100_Am s
Remote Control Circ.
Sp cial inspection S
���
�235
Equipme�t Wirad
Temporary Service
Lighting Fixtures
Electric Heat�nq
Silo Unloader
Bulk Milk Tank
the� ISneci�vl
fes Cirtuita
0 to 30 Am
31 to 100 Am
Above 100_
artia l!Other
� , OTAL FEE
-- I, tAs Electriesl
Inspeetor, h�rsby
certify tAst tAs ebovs
�P insp�ction has b�sn
�3 e3 msde.
s�s-ss-��s-r�rw�ois-
Th�s request w�d �/��� / �"— �w
18 mon[hs�,from ' . � � � �
Request Flre No. Rouph-m Inspecuon
�Q � 9 Reawred? �Readv Now ['j W�It Noufy InsDec-
J C:� ❑ves QNo �or When Ready
L�cens Ele r�cal ContrACtor I h�r�by r�qusst insoecOOn ol abovs
❑ Owner •lectrical work ins�alled st: