P - 79124REQUEST FOR ELECTRICAL INSPECTION
�� 740 �� 1 9 3 a Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800�27-3529 www.electricity.state.mn.us
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ReQUest Date: Rough-in Inspeclion Requiretl? ❑ Yes ❑ No Inspection Other Than RougMn: Reatly Now � Wpl Ca6
/�i p� ��� You must call the inspecla when resdy! Date Ready. . .
I certify tliat t am tlie i�'CICENSED COFfTRACTOR ❑COaPANY ❑ OVYNER and hereby request inspection of ihe elecbic�l wak at:
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