Loading...
3893 Dolomite Dr - Electrical PermitREQUEST FOR ELECTRICAL INSPECTION ?M 1y (_a c ?' See instructions for camplotine this form on back of yellow copy. V X"" SP,-lo,,-Y71?[?)ork Coveted by This Request ES-00001-03 aJ:- 0 0 3110 New }td Type of Building Appliances Wirod Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other Specs v thnr lSpecllyl th S Other Other Compute Inspection Fee Below H_ Fee Service Entrance Size Fes F tlers/SUbfeeders q Fee Circuits 0 to 100 Amps to 30 Am s 0 to 30 Am s 101 to 200 Amps 00 Amps 31 to 100 Am s Above 200 Amps I 100-Amps Above 100_Amps Transtormers g Control Circ. gQ Partial:Other Fee Signs Inspection g TOT Remarks FEE Od /76• Rou h-' ? g Aim / Final ( -• p O? /4' D%ita [ .W I, the rical Inspector" hereby certify that the above inspection has been de. This request void 18 months from This request void 18 months from R1z6 I! (-o45 1-qI 3(oc?c t ( 31q t( Ff ick'(-tic k? 3r! -? (76. 06 Rennes Daler•- eg Fire No. Rough-in Inspection Pequ retl? Ready Now Will Nulify, Insoec] d N. rr When R / 7 es ? No ea y Licensed Electrical Contnctor I hereby request inspection of above Owner electrical work installed at: Street Address, Box or Route No. City ecuon o. Township Name or No. Range No. 0unt4 r+a CIO Oc n (P NT) Id Phone No. /etsoh w eIi -5 5 Power Supplier Cr 1G' Address -rh I,? ie 'IF, M N E ec tricaI C attactnr ICo : ny amen Contractor's License No. sr?? D o73 Mailing Address (Contractor or Owner Making Instailation) 79 B We a?e S, J4 N 3 G 7 . Authorize Siuna tur (Contractor Owner Making lestellaY n) Phone Number - - - -LAC ? D- 5 MIN4SOTA STATE BO;AD OIT ELECTRICITY Y THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone 16121 297-2111 ENCLOSED.