P - 79091REQUEST �OR ELECTRICAL INSPE
1 ° � 1. � -19 9 �9 ��nne'sota Board of Electricily �,- _
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 +�'.: �
(651) 642-0800 TTY/MRS 1-800-627-3529 www.e%ctricity.state.mn.us
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�� �je: Raugh-in Inspection Required? es ❑ No Inspedion Other Than RougtHn: �Ready II Call
7",(p �Q You must call lhe inspedor when ready! Date Ready.
I certify tl�at I am tl1��LICENSED CONTRACTOR 0 COMPANY ❑ OWNER and hereby request inspecdon of the electriral work at:
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BACKOFYE BOARD CiRICfTVCAPY EB-OOOOfA-74 8.1.2002