P - 78206REQUEST FOR ELECTRICAL INSPECTION
1 �� 5�� J� � Minnesota Board of Electriaty
1821 Universify Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TfY/MRS 1-800-627-3529 www.electricitv.state.mn.us
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ReQu�t Date. Roughin Inspection Required? ❑ Yes ❑ No InspeCtion Other Than RougMn: Ready Now ❑ VY�II Call
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`� '��' You must call the inspecla when ready! Date Ready:
I oerti(y that I am the LICENSED CONTRACTOR �COIu�ANY ❑ OWNER and hereby request inspedion of the electrical work at:
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NI87RlICTWtlB OM BACK YELLOW COPY BOARD OF ELECTRICT' COPY EB-000p7M11 8.1. 2002