P - 79225, REQUEST FOR ELECTRICAL INSPECTION
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t821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 www.electrdcity.state.mn.us
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Request Date: Rough-in Inspection Required? CJ Yes L7 No �nspecdon Other Than Rough-In: pReady Now CJ VYdI Call
�7��� You must call the inspecta when readyl Date Ready:
I certify that I am ihe CD�LICENSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby request inspecbon of the electrical wodc at::
IN87RUCTONS ON BACK OF YELLOW COPV BOARD OF ELECTRICRV COPY E@-000�1h14 8.1. 2002