P - 80055REQUEST FOR ELECTRICAL INSPECTION
Minneso}a Board ot Eledricity
1-382-150 � 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651)642-0800 TTYlMRS 1-800-627-3529
www. electricity.state. mn. us
FOR OFFICE USE ONLY
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Ves LJNO � Inspectlon O�her Than Fough-in: Ll Featly Now LJ Will Call
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I certity ihat I am the C7 LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at