P - 79189� REQUEST FOR ELECTRICAL INSPECTION
������ 5 O 8� Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us
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'•w"w"'�"e� Rough-in Inspection Required? ❑ Yes � Inspection Other Than Rough-In: ❑ ady Now � V1ryll Call
����f � You must call the i�spector when ready� Date Read
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I certify that I am the �ICENSED CONTRACTOR �COMPANY � OWNER and herebv reauest insoer.rinn r,f n�p pio,�r,;,.�� w,,.� ,�..
_ _. _ — _' _�.,...�..� � � w�. E&00001M74 8.1. 2002