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P - 82492REQUEST FOR ELECTRICAL INSPECTION 1J �� � ��� � Minnesota Board of Electricity � � � 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104 ` (651) 642-0800 TTY/MRS 1-800-627-3529 , www. electricity. state, mn. us `'�' FOR OFFICE USE ONLY �IIIIIIIIIllll11111i{Illlllllll I�ll�lllllt � s� � • �E 1 O 3 7 9 3 Z 9�E �O ��� 7'S Reques[ Date: Rough-in Inspection Reqwrea'! U res V rvo mspe , O'� I$'O � You must call the inspector when readyl Date I ceRily that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER Job Address (Street, Box, or Route No.) City 55 �'1`�''` � �ric� 1 Ractinn Tnwnchio RBnUB Fre NO. G Sm�-I�'��� �chical Contrador / Company Name DEPENDABLE ELECTRIC. INC. I Coon Rapids, MN 55433 (Authorized Signature (CoMracto ny or Owner Contractor Phone Than v�nn and hereby request inspection of the electrical work at: Nixnber � -!Cp — — —� iv E&OOOOIA-13 7/ BOAflD OF ELECTpICRV COPY N�TRUCTpMS ON B�C� � Y�� COPY