P - 80044�" REQUEST FOR ELECTRICAL INSPECTION
� Minnesota Board of Electricity
` 1-382-147 � 1821 Universiry Avenue Suite 5-128, Saint Paul, Minnesot2 55104
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www. electri ci ty. sta fe. m n. us
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Request Date: qough-in InspeCfion Requiretl? ❑Yes ❑�lo Inspection O�her Than Rough-in: eatly Now O Will Call
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I. I certity that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and he2by request inspection of the eledrical work at: