P - 79492REQUEST FOR ELECTRICAL INSPECTION ��
•�1-13 9-16 0 Minnesota Board of Electriciry
F 1821 Universiry Avenue Suite 5-128, Saint Paul, Minnesota 55104
�n �' (651) 642-0800 TTY/MRS 1-000-6273529
� www.eleciricity.smte.mn.us
IOeMity the work coveretl 6y fiis request: `�1� ��t �'/j� � � �`� yy ���.�//
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Inclutles ihe Service anNOr Power SupPly uD io 500 Amperes, All
iION, REMOTE CONTFOL,
OF LESS THAN 5D VOLTS
FOR OFFICE USE ONLY
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=yueai �a�e. ougn-in inspecipn nequirea'! KJ Yes �J No I Inspection piM1er Than Rwg�-in: ❑ Featly Now�,e'PJill Call I
2""� ���' Vou must call Ne'nspeclor wh dy� pyt q py
I certity ihat I am ihe �I.'fCENSED CANTRACTOR ❑ COMPANY ❑ OWNEfl and hereby reques[ inspection ol ihe eleciricai work a�:
Job Adtlresa �SVceq Box, or Raute Na.l cm� -,... �_._
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