P - 79188REQUEST FOR ELECTRICAL INSPECTION
1��� r�� C o�� Minnesota Board of Electricity _
O J 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTYIMRS 1-800-627-3529 www.electricity.state.mn.us
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Roughin Inspection Required? � Yes O ITo Inspection pther Than Raugh-In: ❑Ready Now � Nhll Call
�7��� Yai must call the inspeGOr when read .
Y' Date Ready:
I certify that I am the �(ICENSED CONTRACTOR ❑ COMPANY 0 OWNER and hereby request inspection of tt�e electrical work at::
-- •-�-•• ��� • oVlVtu Vr CLtGTRICITY COPY EB•OOOOtMi4 8.1.2002