P - 78148REQUEST FOR ELECTRICAL INSPECTION
1� 5 9 9���� � Minnesota Board of Electriaty -
1821 University Avenue Suite S-128, SaiM Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 www.electriciry.state.mn.us
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I certi(y ihat I am the
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Roughin Inspection Required? ❑ Yes ❑ No Inspection Other Than Roughdn: ady Now O VWII Call
Yau must call the inspecta when ready! pete Rp,ady;
NSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby request nspection of the electrical wak at:
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Counry -
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Please Rovide Two (2) Phone Number(s) Induding Area Cc
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ise Number Master Electrician or/P�ower Lvnded T
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EB-00001A-14 8.1.2002