P - 79192REQUEST FOR ELECTRICAL INSPECTION
��� U V- 511 � Minnesota Board of Electricity -
1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-B00-627-3529 www.electricity.state.mn.us
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Request Date: Rough-in Inspection Required? ❑ Yes O'FIo I Inspedion Othar Then Rough-In: ❑I��ady Nwr ❑ Will Call
����� You must call the inspector when ready! Date Ready:
I certify that I am tt�e �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of riie electrical work at:
IN8TRUGTIONB ON BACK OF YELLOW COPY BOARD OF EIECTRICRY CAPY EB-00001A-7! 8.1. 2002