P - 808647 REQUEST FOR ELECTRICAL INSPECTION ��
7�1 �� - 0 5 4� M821eUniversary A ear Rm. 3e128,1St. Paul, MN 55704
- Phone (612) 642-0800 ��
Commercial Indusfriol Farm Remod e air
Air Cand. Hlg. Equip. Water Hir. Load Mgmt Other.�
Dryer Range Elec Heat Temp. Service �'3L.�'�
"X" obove work mvered by this requesL Enier remorks in this spoce ond on fhe back he white copy onl .
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Caltulate Inspeclion Fee - This Inspecfion Requesf will not be occepfed�ouf fhe cortect f�
Other Fee # Service Enhance Size Fee R Circuits/Feeders Fee
Mobile Home Pork Stall 0 to 00 Amps 0 to 100 Amps
Street Ltg./Tmffic Sig. Above 200_Am s Above 100_Amps
Transformer/Genemtor MSPECnTOR'S OSE ONLY �� n�L T
Sign/Oufline Lfg. Xfmr. p� n�if-�,� � �`{
Alarm(Remafe Conlrol ° 7�
$wimminq Pool . , , _ , , _ , , , , „ . , ., „ _ , , ,
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 M6NTHS.
OFFICE USE ONLY This requen void I B monihs hom wlidotion dale pnnhd in fhis 6ox.
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PLEASE PRINT OR TYPE
q"a'� Roogh.n Inspectian required2 ❑ yex o Inspection O�her Thon Rwigh�ln: Ready Now � Will Coll
Z�Vau musr call �he inspeci« when reody� Dote Ready:
ensed contmcfor ❑ owner hereby request inspection of fhe above electriml work af:
69ddress (5vep{�Ba., or Romg No.) Gry� � Zip Code
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