P - 79208REQUEST FOR ELECTRICAL INSPECTION
� � � � Q � � �'9 Q � Minnesota Board of Electricity
V G V 1 g21 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTYlMRS t-800-627-3529 www.electriciry.state.mn.us
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17685280
�t Date: Rough�n Inspection Required? ❑ Yes
07�� You must call the inspector when ready!
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Inspection Other Than Rough-In:
Date Ready:
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Now ❑ NMI Cell
I certify that I am the ❑�ICENSED CONTRACTOR 0 CON�ANY ❑ OWNER and he►eby request inspecdon of the electrical xrork at:
INS7RUCTONS ON BACK OF VELLOW GOPY BOARD OF ELEC7RICRV COPY EB-00001M14 8.7. 2002