P - 79574REQUEST FOR ELECTRICAL INSPEC710N
1� 13 9-16 5 Minnesota Board of Eleariciry
1821 Univereiry Avenue Suite S-128, Saint Paul, Minnesota 55104
�^�� (651) 642-OS00 TTY/MRS 1-800-6273529 -
� www.electnciry.siate.mn.us
IentiTy ihe woM covered by Ihis request:
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ONE 8 TWO FAMILV OWELLINGS. EACH UNR
Includes the Sernce arMlor Power Supply up b 500 Amperes, All
CIRCUITS OF LESS THMI 50 VOLTS
FOIi OFFICE USE ONLY
� i��i�i »��i i�«� ����� ���« ���«�«�� �i«f li« �il�
neIyum� w�e. q noagnin inspecnon neqwrea'! `yYps U No I InspE
(��2,0 �/��I You must call ihe inspeciw wM1an reatly! Date
I certify tha[ I am �he �]'CICENSE� CONTRACTOR ❑ COMPANV ❑ OWNER
Job AdGrass (Sbeel, Bax, or Rou�e No.) Ciry
Own¢r
J/1/2�W
P�one
BOAPO OF EIECTHILRY COPY
2ry �z I
,e���� g �,��
and hereby request inspection of the electrical work aL �
� PUCTIONS�OF VELLDW COVYI ■
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