P - 79207REQUEST FOR ELECTRICAL INSPECTION
��� V O- 5 2 7� Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TfY/MRS 1-800-627-3529 www.electriciry.state.mn.us
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Request Date: Rough�n Inspection Required? ❑ Yes ❑'No Inspection Other Than Rough-In: OFteady Now ❑ Will Call
d7�� You must call the inspector when ready! Date Ready:
I certi(y that I am the �CICENSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby request inspection of the eiecUical work afi:
INSTRUCTONB ON BACK OF YELLOW COPY BOARD OF ELECTRICRV COPV E&00007M74 8.1. 2002