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P - 77219
REQUEST FOR ELECTRICAL INSPECTION 1� 6 8 5- 9 0 5� gyt Unrversiry Avenue 3u�e S- 28, SaiM Paul, Minnesota 55104 (651) 642-0800 TTY/MRS 1-800�27-3529 www.electriciry.state.mn.rts C,�`\� 11 �'L� c��� CiC.��,�— II� IIIII IIIII IIIII IIIII IIIII IIIII IIIII �ql I�I � � 6� . 16859050 � � • I� �' � Rough�n Inspection Required? � Yes ❑ No Irupedion Olher Th� RougMn: ❑Ready Now� Will Call You must call the inspecla when ready! pete Ready; i oertiry that I am the �1 LICENSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby request nspection of Ihe electrical work at: — ....r-, v — — .