Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
P - 79430
REQUEST FOR ELECTRICAL INSPECTION 1 2$ 4 9 8 9 Minnesota Board of Electricity � � 1821 Universiry Avenue Swte 5-12& SaiM Paul, Minnesota 55104 , (651) 642-0800 TTV/MRS 1-800-627-3529 / ' L , �� wwrv.edectnciry.state.mn.us � work c9(ered 6y this [equesC � ❑REMO�EL ❑ADDRION ❑flEPAIR LESS Includes ihe Sernce antllor Paver SuDPIy up ro 500 Amperes, All Circutle anA Tum Insnectinn Tnx Ear.h Dwellina IInB �$& tohdl I herebv �NN Nat I inmectetl tAe eleclncel insfallation desaibetl herein m tl�e AaNS slsl�: � FOR OFFICE USE ONLY III{i111iIIIINllflllllfllllfllill{{1IINIIIIiINf �;#��b� �• 50 Requast Da[e: Rough-in Inspection Requiretl7 ❑ Yes Inspedion Olher Then Hough-In: Ready Now � Will Call i �� Vou must call �he inspac�or when reetlyl Da[e Reedy: 1 cettity thal I am the'�LICENSED CONTRAGTOR ❑ COPAPANY ❑ OWNER afM fiereby request inspectlon of �he elecViral wwk at'. Jcb Atltlress (Street, Boz, w Rwte No.) Ciry _ ,� Zip Cade Phone f\�� Atltlrass or Owne� Petlortniig Installa0on) ' �as�o� �� Ui[.�'a�u �any or Owner Perlorming nstalletion ` �,�� —_—(p (,�..� � lo � � Y�j I °1�a-�ti(3 -�FSd \-13 ]/1,"�p BO/.PO OF ELECTPoCITV COPY INSTHUGTIOHS ON BACK