3335 Coachman Rd - Electrical Permits-1111
This reQUest void
1fl o.u+ntns Qfmrym
1"If7 qZ /?
oU?F01.7
Reqo?st Da Fire No. FnuBh-in IngpecUOn
Feawrad?
?Reatly Now ? WNI NotifY InsDec-
?•l l ?ys nNo Ior When ReaAy
[; L„ensed'ElecVical Convector I hereby request mspecfion oi abuve
? Owner electrmal wo'k installed ac
St et Address, eox or Route No.
« I^
FJ C?tV
ecLOn o. ownship ame or No. ftenge No. 41wm
D :uGnnrt IPRINT)
l? Phone No.
Pawer Sopplie? Atldress
E1 cal Co ractor (Com ny ame) Connar.tor"s Lmense No,
Mailin AdJress (Convacme or Ownet Ma np Instauatmnl
Authonzed Signawre IConV actor/O ner kiny InswllaLOnl
7
L%
Phone Numbcr
MINNESOTA STATE BOAflD OF ELECYRICITY THIS INSPECTION REQUEST WILL NOT
Griggs•Midway Bldg. - Room N•791 8E ACCEPTED 6Y THE STATE 80APD
UNLESS PROPER iNSPECTION iEE IS
1821 U?iversity Ave., St. Paul, MN 55104
Phona 1812) 297.2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION F ee-oouoi_oa
`t ' See instrucbonl comyreong this torm on back of vellow copy. ?
!q??(?J ?'py fl-3U- ?Y
ReQ?Wbrk ?oJered by This Request
HAtl Rep. Type oi 8mlduig Apoliancxs WireC EquiUmem Wved
Home Range Temporary Service
' Dupiex Watei Heater Lightiny Rxtures
Apt. Bwlding Dryer Electric Heatin
Commercial Bidg. Fumace Sklo Unloader
Industnal Bldg. Air Conditioner Bulk Milk Tank
Far01 Othe.rl pea v Oiher ISUerifyl ?
ther SGCUfY Othor Othyr ?
_ompure /nsil hee He/ow -
#. Fee ServmeEnhanceSize R Fee Feaders/5ubfeeAers N Fea
0 to 200 Amps 0 to 30 Am s
A6ove 20l, 31 To 700 qmps
Swimmmy Pool Above 100_Amps
Transtormers Irrigation Boorris ?
Signs Speaal Inspection
S !ry
Rem? r?CS
/ -ri L_ Ub/3 14.1 . ?,,
v? (?qJ'
RouBh-m Unic
Y
Final Oate certdy
that the abave
??? insDectmn has been
?
?('?
matle.
1
i
I
TOTA ? E
U
the E le
I, ical
Inspector
hereb
?- ?--
iI . o. ev. eo?.vio ioruonI neI I - T.
This repuest void `-/
l8 months fram ? d
; CM0.8 4013 ?
a
License lectncal Contrnctor
Owner
SqReet Atltlress, Box or Houte No.
i ? N
ecUOn u. Township ame or
er
Y
uph-ui nsPec?mn
gmred1 ?Ready Nuw Q Will Nobfy InsUec-
]Yes No lor Whyn Reatly
I hereby request mspection of ebove
eleMncal work mstalled at
C ity
19C-AVJ,
?Ae No. Counry
A loTA.
Phone Ne.
Licensc
or Uwnqt Making Inslai
I I I+.4-?/ ._4 ..Wg inseaiia[ionl I Phone Number
MINNESOTA STATE BOAND OF ELECTqICITV
Grig THIS INSPECTION REQVEST WILL NOT
gs-MiCway B?tlg. - qoam N-191 BE qCCEPTED BV THE STqTE BOAqD
1627 UnivarsitV Ave., St. Paul, MN 55704 UNLESS PqOPEP INSPECTIDN FEE IS
_ Phone (612) 297_2717 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION „ ee-oonoi-on
' See instruc[wns for comOletirg (his form on bnck ot yellow copy. "
0??9) 3 - - t ?.3o-?Y
Below Wor overed bv Thic
A.itl Rep. Type ol euiidmB
Hom¢ Applianc03 Wiretl Equ,pment Wired
Range Temporary Service
?uplex
Apt. BwlAinc Water Heater Lightinq Fixtures
?
Commeraal Bldg. Dryer
Fumace Electnc HeaUn
Industnal BIAy.
Air Conditioner Silo Unluader
Farm
Othei pecilv BWk Milk TaNc
thnr UecifY
t?er ther Isuenfy)
Compute lnspectron Fee Be/ow
kFee ServiceEntrance5ae n
Fee Feetlers/Subfeeders
# Fae Crtcwt
0 to 200 Am s
Above 200
0 to 30 qm s s
??? 3? ?"' s
qm )s 37 to 100 Am s
P 31 to 100 Am s
Swimming Pool
Transiormers Atwve 10Am s Ahove 100_Am y
Signs Irrigation f3oorc?s -
pdrval.'Other Fee
Remarks Speaal InsUection $
.?+ 1? .. TOTA EE
Rough-in
Date
I, the lactri
Final Inspacto , ereby
certity thet the above
Dnte
.?
LG
inspection hes been
? ?
iNS repuest vo1018 montns Irom r !
meae.
Thns request void
18 moPths fmm
NW 084016 ?
aequest Da
? rl i?.-on?a EI¢ctncal Contraotor
Y
2 0 . pp I•
IiOUPh-in?InsVecbon qeady Now Q WiII NoufY Inspec
Peqmretl tor When Ready
nY ?N
I hereby rapuest msDec<uon of above
. . . . _?. ...??..?IVA nt_
t
MINNESOTA STATE gOARD OF ELEGTRIt.117 UNLESS.PROPEN INSPECTION FEE IS
Gr{ggs-Midway gld9. - Room N•191
1821 Un.versotv Ave., St. Paul, MN 56104
ENCIOSED.
Phone 161212912111
See in ur SRICA!I INSPECTION
co^olepns thus form on back of Ye ?
llow coPV-
1 ?
084 0?6 f
""X:" Below. 'N ak overed byThis Request
,
Aoalinnces Wired Eq???u?ie??w??eh
F.Atl A.P. TVae oi Builtlin9 TeinporarE ?
? Home Ran e
? LiyhUny Fixtures
Duplex Water Heater
Electric Heatin
'
, - qpt Bwlding Dr
Yer Silo Unloader
. Commercial Bldy. Fumace Bulk Milk Tanl<
Indusinal Bldy. Air Condiboner
_
0111(:1 (sui<<.ity)
' Farm 02ne, Spaufv ,
Other ,
d t e? Specrty
Ot er
I Compute lnspecrion Fee 8e1ow # F9e c„,,,,,g
g Fe0 ServmeEntrance5¢e n Fee FeaAels/Subfeeders ?
0 m 30 Am is
p Yo 200 Amps 0 to 30 Am s 31 to 100 Am s
Above 200 Am?s' 31 to 100 Amps
A6ove 100_.Amps
Swimming Pool Above 100_/amps Partial? Other Fee I
Irngaiion Boon,s _
Transiormers Speciai Inspection $ ,? TOT E -
?
Signs ?
•??
Remarks
r? e- 'Ll 1?
a 42 c'm ?
?
, D''LP I,the IecVi ?
Rough-in InsDecto , ereby
? certify that the above
r D.te onspeevon has been
Final f ?V O made.
I TMSrequeslvoitli8mantRSfmm_ -
u(b b?-? REQUEST FOR ELECTRiCAL )NSPECTION ea-ooooi.oa
, See inatrucpona for cample<vtd this torm on back of ?yellow copy. .
p
1 5
! X'" Belo rk o e d bv This RenuACf
a r,dn Reo• rvaa ot a??m??s a pplionces Wnetl ent Wved
Home Range Service
?uplez Water H
eater
ixtmes
Ap[Bwlding Dryer eatin
Commercial Bldy
Furnace
der
im
?ndustNal Bldg qu Conditioner Tanl<
Farm Oihrr pecty ifvl
tier Su?'.cify
Cam md a Inc narnnn c.,,, a.,r,.... .
a Fee Servi
ae tt Fee Fexders/5ubtaeders M Fe¢ Cu rt
ug
U to 0 to 30 Am ps 0 to 30 Ain
Abom ?s
g 31 to 100 Arnps 31 to 100 Am
Swim Above 100Amps Above 100_Amps
Tran Irrigavon Booms Partial/Other e
Sign
Speciallnspection e
ftem?rks ? S ? TO EE
G,
Rough-in
Da[e
I, ffiB LS
nCAI
h
InsDectoq B?e6y
Final ?
?
?ate certity that the ahpye
f , {ngWecvon has been
mede
rnicem.am???na1.,...,
. .
..
This ?equesi voud ?
18 Tnonffis fmm
wu nRm5 L
? 0cen11[d Eleciri4l Contractor
? Dwner
- - ?-" h?36 -9 y --
z().W
ire No. Rouqh-i InsVecLOn
Reywretl? y_Nuw ? Will NoLfy InsOec-
?Yes ?No tor When FeaAy
I hereby request inspecbon ot above
eIBCtlICaI wnr4 inelellnA a•
Sveet Ad ress, 9ox or Foure No.
3 C'ry
ecUOn a. Ta nship Name or No. Ronge o. Coun
D upant IPflINT?
I,L N(G pa Phone No.
PoWer Supplier Atldress
E i al ConVactor (COmpa N el
Conhactor's License No.
Mailine 6 dress IConVactor or O er
(s'
' akinB InstailaLOnl
ut or¢ d Signature onhactor/Ow r Making InstallaLOn) P one Numb^e/r
??
mirvrvtaViA $TATE 90AflD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs•Midwey Bldg. - Aoom N•197 BE ACCEPTEO BY THE STATE BOAHD
1821 University Ave.. St. Peul, MN 55104 UNLESS PflOPEH INSPECTION FEE IS '
Phone 1812) 297.2111 ENCLOSEO.
This request voitl
? 18 months from
EM 084014 C-
, Request a[e? Licensed Electrcal ConVactor
? Gwner
11?3a_? y
!./ v ! j 0?1- ZC; . i?J
re Na. Rouqh?m Inspec'ion
FeqmreA1 OReatly Nuw ? W?II Notity Inspec-
?les oNo [or When Readv
I hereby requesl inspection of a6ove
Sveet Address, Box or koute No
.
MAN ciiy
ecLOn o. owns up Name ur No. pange Na. C.ii??ty
b"ftrA
Occ ant IPflINTI
Ph
Ni
one
C
Power $upppgr
Address
E t al ConVactor ( omp Y ame) Coniractoi's Licenee No.
ailing qddr s bntrer,[or or Owner a ng Ins,aJauon)
O
Aut o i d SiBnewre Conha/? cmr Owne aking histaiiatwn) Ph ^e umber
?
----?•? ouainu ur el-l,einielTY Ims irvsrECIION REQUEST WILL NOT
Griggs_Midwey Blde. - Aoom N-191 BE ACCEPTED BY THE STATE BOAHD
1821 University Ave., St. Peui, MN 55100 UNLESS PROPEH INSVECTION FEE IS
Phone (612) 297.2771 ENCLOSEO.
REQUEST FOR ELECTRICAL INSPECTION „ EB-00001-04
' See instruchons tor complatine thia torm on bnck of yellow copy. ?'1!"" BeowW ?rQJ:
ov red by 7his Reouest' Adtl Rap. Type ot Bmldinq AppLancns Wired Equqmiant WneA
Home Ranye Temporary Service
Duplex Water Heater Liyhtiny Fiz[ures
Apt. Buiidnrt7 Dryer Electnc Heabn
Commerc?al Bldy. Fumace Silo Unloader
Industrial Bidg Av Conditioner Bulk Milk Tank
Farm Other or,?PV Omer ISnuc?lvl
.
t er Sueufy Other 01h.,
_ '"'_ ..._r.......,.. , w .+o,....
# Fee Servica Enlranca5ae k Foe Faednrs/5abtentlars 7 ?^- ^-------
U to 200 qmps 0 to 30 Am s
Above 200 qmps 31 to 700 qmpy
Swimminq Pool Above 100_Amps
Transtormers Irrigation Booms
Signs Special InspecUon $
? r / A L. 11(l} A/I s..?f. .M. . r.nn ..
to
TOT FEE'
% _O
Roueh-in `?`""` `
Date
?
1. t ncal
? 1I19pBCIol, hpfOby
Final cerdiy [hat the above
? u:"",a6, , ?soec c, o?, nas baen
?( ? meda.
2954 al .3
Requ st Date '
3 / h Z Frte No Rou9n-in Inspadion
Reqmretl+
G ReaOy Now ?Nill Nooty Inspector
?
V •.? G Ves No W?en Reatly
IXlicensed contractor E) owner hereby request inspection of above electncal work at:
JoD Atltlress (Sireet. Box or Route No ? n Ciry
3 3 3 5 ?-?Cl?,,,,,,,,, . 5 S 2l l
Seceon ?lo Township Name or No qanqe No Counry
OccuOaMIPRINT? Phone No
? c c //f /
4 J ? J ?
Power Supplier Atltlress
Elpqncal Convado, I ^
z? , ? ConVac[or5 Lcense No
G
z
.. d?-? . o
7
Mailing qaaress iConiroc Ow r Making nstallalio
?7?3s D,? . ? . SSyY?'
A
Aumonzed Si wre IConvacton0 ar Qa\ing Installat
ilifir) Phone Number
^ ss 9Y??q I
MINNESOTA E BOAND OF ELECTHILI
Grlggs-MiEway Bltlg - Room &173
1821 Univerolly Ave., SI Paul. MN S5104
VMne (612) 6b2-0800
THIS INSPECTION REQUEST WILL NOT
6E ACCEPTEO BV THE STATE BOAFD
UNLE55 PROPER INSPECTION PEE IS
ENCLOSED
3/? /?3 REQUEST FOR ELECTRICAL INSPECTION `? `?^e es-ooomoe
i 2 9 5 4• See ms:rncpons foncomplehng this form on back oi yellow copy ???li
o-?? v v
X" Be%w Work Covered by This Reouest ?
ew Ado Rep Typeoigwltling AppliancesWired EqmpmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Buntlmq Dryer Other (Speciy)
Comm./Industrial Furnace
Farm Au Conditioner
Othar (sl ConV9cbB FemaMs
Compute Inspection Fee Below:
# Other Fee # ServiceEnirance5¢e Fee # Qrcmts/Peetlers Fee
Swimming Pool 0 to 200 AmpS 0 to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
Signs Inspecmr§ Use Ony TOTAL
Irngahon Booms ?? . ? s?
?
Special Inspecllon
Alarm/Communication THIS INSTALLATION MAY 8E ORDERED DISCONNE
TE
Other Fee C
O IF NOT
COMPLETED WITHIN 78 MONTMS.
I, ihe Elecincal Inspector, here6y R?u9h-1O oate
certify that the above inspectwn has F,nai
been made oa'?
OFFICE USE JNLY
Tnis reQuest vaE 18 ml Imm
J
95 ?.3
a 25
REQUEST FOR ELECTRICAL INSPECTION
I? See insVUCLOns foe complenng thi5lorm on Md ol yellow copy
'X" Below Work Covered by This Request
EB-00001-08
` ?.
ew Add Rep , Typeol8wldmg ApphancesWiretl EqwpmenlWired
dome Range Temporary Service
Duplea Water Heater Eleciric Heatmg
Apt Butlding Dryer Olhev-(Speciry)
Comm./Indusirial Furnace
Farm Au Conditioner
DIhBf I6GBGilY) OOIIfYdCtO!'6 RBllldlk6
Cpmpute fnspecfion Fee Below.
# Other Fee # ServiceEntrance5ize Fee # GrcurtslFeeders Fee
Swimming Pool 0 to 200 Amps 0 fo 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
Slgns Inspector's Use Only TOTAL ?+Q
Irriqahon Booms
Speaal Inspection
AlarmlCommumcation THIS INSTALLATION MAY BE ORDER ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electncal Inspectoc hereby AOi Da[e
certify that the above inspection has
been made. F,,,ai
OFFICE USE ONLY
This rei voitl 18 momhs irom
I
7? ? V V `3
00
9?
3
/??'
??°
3//5
u
,
Request Dide
• Fre No Rou9h-in Inspection
Fequrtetl?
? Ready Now, dy Notity Inspecror
? ? D ? [ Ves o Wnen Ready'
I;] licensed contractor ? owner hereby request inspection of above electncal work at:
Job Atldress (SVeet Bax or Route No ? C'ry
3 3 `f 3
Secnan No Township Name or No Range N. Counly
Oaupant (PRINT) Phone No
y5y-57l
PawerSUppiree
e? Atltlress
Elxmwl Conhacto, ICompany Name) Comracti Lioense No
'-?
z
to
r
Ma/ilmg Atltlress (COniroctor W n M kmq I sblletion)
C
PuIDOnzetl gnature (Cmtreclon0 Making InstallaLOn) Pb e Number
i?. 7?.?er : di-? n
MINNESOTA TE BOAHD OF ELECTR Y TNIS MSPEGTION REQUEST WILL NOT
8E AGCEPTEO 6V THE STATE 90ARD
Griggs-MiAway Bbg - Floom 5493 UNlE55 PPOPER INSPECTION FEE IS
1821 Unlvarsity /.ve., St Paul. MN 55100 ENCLOSED
Ghone(61])fid2-0B00
N -7e)aG-7
MINNESOTq S]AfE BOAqD OF ELECTq
Gnggs-Mitlway Bltlg - poom S173
1821 Umversity qye., SI Paul, MN 55100
Vhone (812) 662-0g00
c3? S 19? REDUEST FOR ELECTRICAL WSPECTION
? 72 9 5 7 See inslrutlrons fm rom0lehng ihs form on back oi yellow copy
- _ 'X" Below Work Covered by This Request
ew Atld Rep Typeof8wlding ApplianceSWired
Home Range
Duplex
. Water Hea[er ?
_--+?- - - .
Furnace
Air Candrtioner
??ner(spea?v)
Compute lnspechon Fee Selow? Other Fee
Signs
eooms
Alarm/Commumcation
Other Fee
I, the Electncal Inspector, hereby
cerhfy that the above inspection has
been matle.
OFFICE USE ONLY
ihis request vaitl 18 monihs imm
D to 200 A
Above 200
:tor's Use On
THIS INSTALLATION MAY BE
COMPLETED WITHIN 78 MOh
Fee
??.?;? 0?83 3
Service
ro
Fee
?
DISCONNECTED IF NOT
inos irvi,vt6TIpN REOUEST WILL NOT
8E ACCEPTED BV THE STATE BOARD
UNLESS PFDPER INSPECTION FEE IS
ENCLOSED
MINNESOTA 5,11r1 C BOARO OF ELECiq
Gnggy.MlEway Bldg. - Room 5-173
1821 Univerel[y Ave, St Paul. MN 55100
Phone(612)6G2-0800
3/?5 '3 REQUEST FOR ELECTRICAL INSPECTION
?5, ea.ooooi-oa
nn ll ??/1 ? See inshuctions for complebng this lorm on back of yellow copy ' 'f-?y-gei D a?
111 C V il.i4?" ' O ?..7
X" Below Work Covered 6y Thrs Repuest Ntw'..
vew hoo nep " TypeofBmlding ApphancesWired
EqwpmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Bwldmg Dryer Other (Specity)
Comm/Industrral Furnace
Fafm Air CondRioner
Other(sVemty) Contractor5 Remarka
Compufe Mspection Fee Below:
# Olher Fee
Booms
I, the Electrical Inspector, hereby
certify that the above mspection has
been made
)FFICE USE BNLY
'nis request witl 18 monihs irom
# ServiceEntrance5rze Fee # Circmts/Feetlers Fae
0 to 200 Amps 0 to 100 Amps ?
Above 200 _ Amps A6ove 100 Amps
Inspectors Use Only TOT(1L?
16 ? ? s a
THIS INSTALLATION MAY BE ORDER DISCONNECTED IF NOT
COMPLETED WITNIN 18 MONTHS.
3.
?
i n15 INSPECTION REpUESi WILL Npi
BE ACCEPTED BY iHE STATE BOARO
UNLESS PqOPER INSPECTION FEE IS
ENCLOSED
? 72956 ?&?3
?
? 00
/
5 ?.3 ?;? . ,? ?.
??,C ? ?•
ReQUest Dale '
3??O ? Fire No Rough+n Inspection
qaqui?,
J?eS Na ?
? Reatly Now Will Notiry Inspectw
wnem aeaay+
I licensed contrador p owner hereby reque5t mspection of above electncal work aC
Job Atltlress (SVeel Box or Route No ) City
33 51
Seclion No Township Name or No Range No County
OccupantlPRMT)
&Z&z Prone No
? sy s7?s
PowerSuppber Atltlress
Electrical,GOnVa[tor IConpany Na
_V?/• mel ? ConVactor5 LKense No
B F- U
Matlmg Atlaress ICOnb or Owne Makin I nstslla?i nl
r?j
? ? J? ?
%
[7f35 O iit
Autnor¢etl qnaWre IConhatlor?Ow er Makmq Inst lion) PM1One Number
559K
MINNESOTA TE BOARD OF ELECT ITY THIS INSPECTION FEOUEST WILL NOT
Grlggs-MlEway 61E9. - peom 5.173 BE ACGEPTEO BY TME STATE BOARD
1621 Univarslry Ave., SL Vaul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Fhom (612) 862-0800 ENCLOSED
3/572956
RE4UEST FOR ELECTRICAL INSPECTION
? See instmMions lor completing tnis lorm on back of yellow copy.
- "X" 9elow Work Cavered by This Request
E8.00001.08
ew Add R lding AppliancesWired EquipmeniWiretl
Range Temporary Serv ice
Water Heater Electnc Heating
c Dryer Othec(Speciry)
ial Furnace
Air Condtlioner
Conhacmr's Ramaeks
Compute Inspechon Fee Below
Other Fee # ServiceEn lranceS¢e Fee # Circuits/Feetlers Fee
ing Pool
rmers
4 0 to 200 Amps
Above 00 Amps 0 to 100 Amps
00 _ Amps
Signs InspedorSUSeOnly ? TOT?C 5;o
Irngation Booms
Speaal Inspeciion
AlarmlCommunicatwn THIS INSTALLATION MAY BE 0 RED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in oate
certdy that the above inspecllon has
been matle Final
OiFICE USE'JNLY
This request voitl 16 manlhs imm
r -
256-3 3 0 21
PLEASE PRINT OR TYpE OFFlCE USE ONLY Thus reqoesl mid 78 monihs (rom volidohon dafe pnmcd in this box
?F
Reqmn Dane
U Rough-in inspeeion requvedY
es
(Yo
-
t
ll M No Ina eion Olher Thon Rmih.In
pe p [I Ready Now ill Call
o mus
m
a inspeclor
?rod?) ?ah Ready.
I, licensed conlmctor ? owner hereby requesf inspedion af }he ahove eledncal work of
lob dmss r, Box or Route No j clry
2p Cade
??v h(,.J
RN
{L?
SMton No. Township Nome or N.
Ronge Na. Firc No Counry
? 0l?ha t'
„ on, .
'o rn l?sr?- Phon<No
PovrerSoppLer Address
E? ?ol Contmcior (lCOmpony Namel , Canhocmr L«nse N. M star Lc N. (Plonl Eled Only)
Q- mo
0
Moiling Addreu (Conlmtloi or Qmer Pe ortninu Insbllaban)
1 .1 1< ( A.AJ
h
? ?
ith SignoNre (Connocior or Owner PerPo
y iin:ronotminj Phone No.
? -atao
EB- IA-10 6/95 - e.....'?"'" __-
- r. ?ccir?JnuciloN50NBACKOFYELLOWCOGY
?I?IIIIIIC RE4UE5T FOR ELECTpICAL INSPECTIONMinnesota State Board of Electricity Rm.
28, j#Mjjjjjjjjjjjj * Pno?e (s1z)s? a2 V-osoo r?n /9/Paul, MN 55104
Home Dup ez Apt. Bldg ' Oiher: D New Addn
Commercial Mdusirial Farm 1 ??L h Remod Re air
Air Cond. Hfg. Equip. Wafer Htr. Load Mgmf JIher`J
.
D er Ron e Ele<. Heat Tem Service
"X" obove the work covered 6y thu request. Enfer remorks m this space and on the back of ihe whde copy only.
?[l..l. ?./-!?(1b?S
?
` I99 'lVO?
3?f ?
1-
Calculote Inspectwn Fee - This Inspecfion Request wdl not be accep/ed wrthouf the corrzcf fee:
Olher Fee # Service Enharup 5"¢e Fee ¥ Circuils/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Streef Lfg./Troffic Sig. Above 200 Amps k4bQyV 100 Am s
Tronsformer/Genera}or INSPECTOR'S USE ONLY 7 pL
Sign/Outline Lig. Xfmr.
•O
Alarm/Remofe Control ?/
$wimming Pool
Irrigo}ion Boom I here ni th n' I IlaAan dexcn6ed herein on the daks zrakd
kough n D
L
$pecial Inspection aro
/
?
Investigotrve Fee F'"°? ?re
7HIS INSTALLATION MAY BE ORDERED DISCONNECTEO IP Nor r.nwo. crcn