P - 79016c REQUEST FOR ELECTRICAL INSPECTION
1- v o�— 6 6 8 I�! � Minnesota Board of Electricity -
L J 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651)642-0800TTY/MRS1-800-627-3529 www.electricity.state.mn.us
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"`�"Q" 1°�C� Rough�n Inspection Required? ❑ Yes No Inspection Other Than Rough-In: ❑Reedy Now II Call
"��—�--Q[„�, Yau must call the inspector when readY! Date Ready.
I certify ihat I am the �ICENSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby req�st inspection of the electrical work at:
....,...••••• �••�y r . . � . EB-00001A-14 8.1.2002
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