P - 79222REQUEST FOR ELECTRICAL INSPECTION �
�. � 7 6 8` J�} �� Minnesota Board of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TfY/MRS 1-800-627-3529 www.electriciry.state.mn.us
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Request Date: Rough-in Inspection Required? ❑ Yes a"No Inspecfion Other Then Rough-In: C7Re+�dy Now L7 VY�II Call
07��� You must call the inspeclor when ready! Date Ready:
I ceAiiy tliat I am tlie �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby �equest inspection of the electrical work at::
INSTRUCTONB ON BACK OF YELLOW COPY BOARp OF ELECTRICITV COPY EB•OOOD1M14 8.7. 2002