P - 80579� REQUEST FOR ELECTRICAL INSPECTION
� Minnesota Board ot Eleciricity `
1-380-310 � 1821 Universiry Avenue Suite S428, Saint Paul, Minnesota 55104
(651) 642-08�0 TTYfMRS 1�800-627-3529 -
www. electiicity. sta te. mn. us
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Request Da�e: Rough-in Inspection Requirse? ❑Yes ❑ Inspection Olher Than Rough-in: eady Now � WIII Call
You must call �he inspecto� when reatly! Date Reatly:
I certity that I am ihe � LICENSED CONiRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the eledrical work a[: