3284 Donald Ave - Electrical PermitREQUEST FOR ELECTRICAL INSPECTION EB-00001-07
2/?/ V ? Se9instructiom for completing this form on back of yelbw wpy ?^ ?? y?
I ' 3 4 8 8 9 X" Below Work Covered by This Request
New Add Rep. Typeof Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater tric Heating
Elec
Apt. Building Dryer er
Oth (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) Contractors Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Above 100 Amps
Signs Inspectors Use Only: ,
)
/ TOTAL Sd
Irrigation Booms O C
J,> C
Special Inspection
Alarm/Communication -
Other Fee
I, the Electrical Inspector, hereby
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OFFICE USE ONLY
This request void 18 months from
Req ate File No. Rough Inspection 61
Required?
? Ready Now ? Will Notify Inspector
El Yes ? No When Ready?
1 ? licensed contractor ? owner hereby request inspection of above electrical work at:
Alth Adgr s (Street, eax or uee No) City
Se rioonn No. Toxnship Name or No.
` Range No. County
an (PRINT) UO
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%wer Supplier // .w
) Address
Electrical Contractor (Company
Name) COW ct el- No.
KENDRICK ELECTRIC
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MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Grlggs-Midvray Bldg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone(612)642-0800 ENCLOSED.