P - 79442REQUEST FOR ELECTRICAL INSPECTION ��
19 0 6 61 Mmnesota Board of Eleariciry �
� � � � 1821 Unrversrty Avenue Suite S-12B, Saint Paul, Minnesofa 55104
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(651) 642 OB00 TTV/FARS 1-800-627-3529
www.electriciry.staae.mn.us ������
y Ihis request
❑ADDITION ❑REPAIR
InGudes the Sernce anNor Power Supply up to 500 Amperes, All
Circui�s and Twn Insreclion T�ios E3Ch UxBllinU Uflll �$8C
FON OFFICE USE ONLY
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10�31 �PR IS
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Request Date: Pough-in Inspec[ion RequiretlP �J Ves `�NO Inspection O�her Than RougRlm �J ReaOy Now,�9Vlll Gan
)� i�t—�/ You mus� call t�e inspeclo� when �aetly! Da[e Reatly:
I cetlify that I am the�ICENSE� GOMRACTOR ❑ COMPANY ❑ OWNER antl hereby requesl inspeclio� of the electrical work at:
Job Address (Sbeet. Box, or Rou�e No.) City 2ip Cotle
5�31 ��° 5� �Ub �'�d(2� ��1�
Occupant
T[�Y1 I
V
ELECTH INC.
AVE. N.E.
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