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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 if h h b i i h Rough-in Date y t cert at t e a ove nspect on as been made. Final Oatg - 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 1'f el-V Phon -5-- 7/J %wer Supplier // .w ) Address Electrical Contractor (Company Name) COW ct el- No. KENDRICK ELECTRIC Mailing All, ,FF MiEANgldgghs atpn)A N-E rG1V 1V lll ..11 1.t11V P? x 194 AAirk, Aulh ?f ( Phone Nu ber 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.