P - 79147REQUEST FOR ELECTRICAL INSPECTION
1•� ?��� 4 6� � Minnesota Board of Electricity �
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
J (651) 642-080� TTYlMRS 1-800-627-3529 www.electricery.state.mn.us
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*��� �= Rough-in Inspection Required4 �Yes ❑ No Inspeciion Other Than RougMn: OReady Now Will Call
12-8-04 You must call the inspector wh� rp,ady! o�� R�y:
I cerMy that I am 1he �l LICENSED CONTRACTOR 0 COWIPANY ❑ OWNER and hereby request inspection of tt�e electrical work at:
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