P - 79429REQUEST FOR EIECTRICAL INSPECTtON ��
1 3 4 0 610 Minnesota Board of Electricity
� � 1821 Univereiry Avenue Suite 5428, Saint Paul, Minnesota 55104 .?.�
� r*na-� (651) 642-OS00 TTV/MRS 1-800-627-3529
www. electriciry. state.mn.�s
I �NEW ❑REMODEL ❑AODITION ❑REPAIF
LESS THAN 5�
�
ONE 8 TWO FAMILY �WELLINGS, EACH UNIT
Inclutles the Service anNOr Powe� Suppy up to 500 Amperes, All
Cirouits and Two Insoection Trios Each Dwellina Untl �$&
"�(/�./6�2� •Oti
FOR OFFICE USE ONIY
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I ceniTy ihat I am
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You must call ihe irispe�MO� whe� reatly! ' � �ale Reatly. ��.
:NSED CANiFiACTOR ❑ COMPANY ❑ OWNER and hereby
Range
total fee is
Ihe Oates
��. 5�`� �,��
of ihe eleqrical work at:
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EB-04001A49 �It2000 BOAHD OF ELECTPILrtY COVY INSTRUCTqN5IX1 Bl�CK OF VELLOW COPV