P - 80580REDUEST FOR ELECTRICAL WSPECTION
., Minnesota Board of Electncity ��
1-380-311 � 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104 ;
` . (651) 642-0800 TTYIMRS 1�800-627-3529
www. electiicity. s ta te. mn. us
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FOH OFFICE IISE ONLY
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Request Date: Rwgh-in Inspection Requiretl? ❑ Ves ❑ Inspec[ion Olher Than Fough-in: eady Now � WIII Call
Vou must call the inspector when reatly! �ate Reatly:
I cetlity that I am the � LICENSED CONTAACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of ihe eledrical work at: