P - 79297REQUEST FOR ELECTRICAL INSPECTION
�%` % � Minnesota Board of Electricity -
� 1 f�- 5 5 2 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� (651) 642-0800 TlY/MRS 1-800-627-3529 www.electricity.state.mn.us
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Request Date: Roughin Inspection Required? ❑ Yes Q'�lo InspeGion Other Than Rough-In: �Ready Now � INII Call
���"���Q You must call the inspector wF�en ready! Dete Ready:
I certify that I am tl�e [�.ICENSED CONTRACTOR ❑COMPANY ❑ OWNER arid hereby request inspection of the elecfrical work at:
� MSTRUCTIONS ON BACK OF YELLOYY COPY BOARD OF EIECTRICITY COPY EB-a00otA-5a n.�. 2w'[