4024 Nicols Rd1'his request void 18 months from "'7'e 1-9 pk /Z?5" = R. tjr cF{ '?' 7 3 60
. / ? ?0.377
Date of this Request 60888
I, as O Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at: Lo -t 2, 3 d- R} 6.41e; p Jeec. (4AT C E oqR c,pa,,e y5
Street Address or Route No. N P_ C+a,P. C E Q4R?-C?A/trv€t?pd City ?4An[
Section Township Range County DA -?e>TfI
Which is occupied by e7dLCJ ? i0 SSa ?,
(Name oi occupant)
Is a roughin inspection required on this job? No H' Yes ? Ready Now ? Will Call ?
p 300? Ml?o?H4..Si ?
Power Supplier ?'S ! Address Nc 1..? Tx/t'? ?`l. 6S0 `SS
vAA'Z1 Ic?f/?`/ o ?ntractor'sLicense'N937/7
Electrical Contractor ? !/'? /r o. _
( ompan?y/ f??a?me)?
MailingAddress !,/L?/-----????@?J?pi?C/?
(E (ICaI Contfactor wne( Makl g Ttlls Installatlon)
Authorized Signature ;4/"Z'1 Phone No.S ?I-J.939
( I r a on1rac or or Owner Making This Installatlon)
Rft This i?pectian request will not he accepted 6y the STATE ?OARD COPY : State Board unless proper inspection fee is enclosed.
Minnesota State Board of Electricity
1954 University Ave., St. Paul, Minn.551D4-Phone 645-7703
t
,-REQUEST FOR ELECTRICAL'tRLSPECTION
CHL.CK BELOW WORK COVERED BY THIS REQUEST
/19::p C?r 7 7
P 60888
Type of Building New Add. Rep. Check pppliances Wired Foi Check Equipmerti W'ved For
Hume ? ? ? Range ? Temporary Wiring
Duplex ? ? ? Water ? Ligh[ingFVCtures ?
Api. Bldg. ? ? ? Dryex ?' Elecuic Heating
Commercial Bldg. ? ? ? Furna Silo Unloadei ?
Industrial Bldg. 0 ? ? Air C itio Bulk Milk Tank ?
Farm ? ? ? Lis[ List )
Othec
?
?
?
HehelS? }
Here 51
COMPUTE INSPECTION FEE BELOW
Service Envance Size: # FeedersRSubfeedeis: # Fce C¢cuits: # Fee
0 ro 100 Am s. 0 ro 30 Am eres 0[0 30 Am eres
101 to 200 Amps. 31 to 100 Amperes 31 to ]00 Am eres
Above 200 Amps. Above 100 Amps. Above I00 Amps.
Transformers RemoleControlCirc. Partialorotherfee
Signs Special lns ection Minimum fee E5.00
Remarks
TOTAL FEE
I, the Electrical Inspector, hereby certify that the above inspection has been made.
(Rough-in) Date
(Final) ?'J' Date 6- 7 - 7 g
This request void 18 months from