P - 79412REQUEST FOR ELECTRICAL INSPECTION
1 18 9 7 3 2 Minnesota Board of Eledricity �
� � 1821 Universiry Avenue Suiie S-128, Saint Paut, Mlnnesota 55104
!'� (657) 642-0800 TTYlMRS 1-800-6273529
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❑NEW ❑REMO�EL ❑ADDRION
Indodes me Service anNor Power Suppy up [o W� Amperes, NI
total fee iS
FDfi OFFlCE USE ONLY
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I �/ V 1 1� (1 (�/�1 � You mus[ call ihe inspeaor when ready! I Oate ReaEy: ��� �� ����I
i I ceroty that 1 am the Q}LlCENSED COfdTRACTOR ❑ CpMPANY ❑ OWNER and hereby request inspedion of ihe eledrical work at:
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